Working paper of public health最新文献

{"title":"Implementation and impact of Fast-Track in an Emergency Department: pre-post study","authors":"Carlo Alboreo, R. Di Matteo, Gianluigi Piazzolla, Lucia Di Nardo, Giuseppe Dipaola, Enkeleda Gjini, Emanuele Tatò, Alessandro Scelzi, A. Maconi, T. Bolgeo, Federico Ruta","doi":"10.4081/wpph.2024.9877","DOIUrl":"https://doi.org/10.4081/wpph.2024.9877","url":null,"abstract":"Background: overcrowding and long waiting times are major problems in Emergency Departments (EDs). Fast-Track (FT) is a process developed to more effectively manage patients admitted to EDs with non-urgent conditions. The aim of the study was to evaluate the impact of the FT method regarding access in an ED. Materials and Methods: pre-post implementation study of the FT method. All patients attending the emergency department of the ASL of Barletta presenting minor emergencies with problems in the obstetric/gynaecological, ophthalmological, paediatric, otorhinolaryngological and orthopaedic areas were included. Results: of the 38,024 services performed in the ED, 1606 (4.22 %) were FT accesses. Analysing the data from the period May 2017 (pre) and calculating in minutes the waiting time from triage to discharge is 55 minutes; instead in the period May 2022 (post) it is 20 minutes. Conclusions: the FT method seems to be a useful and safe strategy to improve the management of patients admitted to emergency rooms with minor disorders.","PeriodicalId":489652,"journal":{"name":"Working paper of public health","volume":"66 28","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140663807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunoterapia adottiva mediante Infusione di Linfociti da Donatore (DLI) dopo trapianto allogenico di cellule staminali emopoietiche e monitoraggio del chimerismo","authors":"Camilla Zani, Roberta Neri, Giuseppina Balza, Maria Grazia Verri, Marika Cagnati, Manuela Arata, Zallio Francesco, Paolo Rivela, Thea Bensi, Mauro Patrone, Lia Mele","doi":"10.4081/wpph.2023.9644","DOIUrl":"https://doi.org/10.4081/wpph.2023.9644","url":null,"abstract":"Obiettivi: il trapianto allogenico di Cellule Staminali Ematopoietiche (CSE) è un importante trattamento per i pazienti affetti da patologie ematologiche in quanto può indurne la remissione; tuttavia, la recidiva di malattia è una delle cause più importanti di fallimento. L’immunoterapia adottiva rappresenta un nuovo approccio terapeutico contro i tumori ematologici, affiancandosi e a volte sostituendosi alle terapie tradizionali, quali chemioterapia e radioterapia. L’Infusione di Linfociti da Donatore (DLI), ovvero l’infusione di linfociti dello stesso donatore allogenico di CSE, rientrano all’interno di tale terapia in quanto hanno lo scopo di ripristinare le capacità difensive del sistema immunitario, rappresentando una possibilità di cura per il paziente. Presso il settore di Processazione CSE della SC Medicina Trasfusionale dell’Azienda Ospedaliera Santi Antonio e Biagio e Cesare Arrigo di Alessandria, è stato eseguito uno studio retrospettivo in pazienti ematologici trapiantati, afferenti alla SC Ematologia, allo scopo di valutare se il monitoraggio del chimerismo, eseguito su sangue periferico, linea linfoide, linea mieloide e midollo osseo pre e post infusione di DLI potesse dare informazioni al clinico circa l’efficacia dell’immunoterapia adottiva. Materiali e Metodi: lo studio del chimerismo è stato effettuato mediante Polymerase Chain Reaction – Short Tandem Repeats (PCR-STR). Tale tecnica utilizza polimorfismi genici, gli STR, ripetizioni in tandem di piccole sequenze nucleotidiche che si ripetono n volte. Si individuano tre differenti situazioni: i) chimerismo completo, le cellule del donatore sono >90%; ii) chimerismo misto, coesistenza nel ricevente delle proprie cellule e di quelle del donatore presenti in un intervallo che va dal 20-85%; iii) chimerismo assente, ricostituzione emopoietica autologa, cellule del donatore <20%. Risultati: una prima analisi dei dati evidenzia che la distribuzione dei pazienti all’interno delle varie patologie risulta essere disomogenea. Si è quindi ritenuto di raggruppare i pazienti in base alla patologia ematologica di appartenenza. Nei pazienti affetti da Leucemia Mieloide Acuta (LMA) i dati ottenuti mostrano che 14 (54%) sono deceduti a causa di complicanze nonostante l’infusione di DLI. I restanti 12 pazienti mostrano un tasso di sopravvivenza del 46%. Nei pazienti affetti da Leucemia Linfoblastica Acuta (LLA) i dati raccolti evidenziano che 4 pazienti risultano deceduti con un tasso di mortalità pari al 50%. I restanti pazienti mostrano un tasso di sopravvivenza del 50%. Nei pazienti affetti dalle restanti patologie Linfoma di non Hodgkin (LNH), Mielodisplasia (MDS), Linfoma di Hodgkin (LH), Mieloma Multiplo (MM), Leucemia Linfoblastica Cronica (LLC). È possibile, quindi, osservare come anche nel caso di questo gruppo di patologie, la percentuale di mortalità è del 50%. I restanti pazienti mostrano un tasso di sopravvivenza del 50%. Dei 47 pazienti, 34 (72%) non hanno sviluppato Graft versus Hos","PeriodicalId":489652,"journal":{"name":"Working paper of public health","volume":"6 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139684763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"L’importanza della valutazione radiologica mediante tomografia computerizzata nella diagnosi di osteonecrosi delle ossa mascellari correlata a farmaci: studio osservazionale RAD-ONJ. Analisi preliminare della popolazione in studio","authors":"Antonella Fasciolo, Riccardo Campora, V. Fusco, Costanza Massarino, Francesca Marengo, Giorgia Rossetti, Paola Brigo, Ivan Gallesio, L. Benzi, M. Rossi, F. Monaco, M. Ladetto, A. Maconi","doi":"10.4081/wpph.2023.9786","DOIUrl":"https://doi.org/10.4081/wpph.2023.9786","url":null,"abstract":"Background: la Osteonecrosi delle Ossa mascellari farmaco-relata (Osteonecrosis of the Jaw, ONJ), recentemente rinominata a livello internazionale Medication-Related Osteonecrosis of the Jaw (MRONJ) è una malattia di recente individuazione (2003), caratterizzata da alterazioni che includono segni e sintomi clinici (includenti ma non limitati all’esposizione ossea in cavo orale) assieme ad alterazioni radiologiche alle ossa mascellari superiori e alla mandibola, meglio valutabili con Tomografia Computerizzata (TC). Abbiamo disegnato uno studio osservazionale, (retrospettivo e prospettico) per investigare sistematicamente il tasso di presenza dei vari segni radiologici alla TC, predefiniti secondo un elenco (osteosclerosi focale e diffusa; sequestro osseo; interruzione della corticale; reazione periostale; osteolisi; ecc.) in casi di MRONJ studiati con TC al momento della diagnosi clinico-radiologica, secondo i criteri delle Raccomandazioni Italiane SICMF-SIPMO (2020). Risultati: da Marzo 2022 a Marzo 2023, sono stati esaminati 120 pazienti; cinque sono stati considerati non elegibili per assenza di materiale iconografico adeguato. I dati clinici e le caratteristiche radiologiche (TAC) di 115 pazienti sono stati caricati su software. Conclusioni: il campione è risultato maggiore dell’atteso e sembra sufficiente per procedere alla valutazione finale.","PeriodicalId":489652,"journal":{"name":"Working paper of public health","volume":"54 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139594068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SARS-CoV-2 vs Streptococcus pneumoniae: a comparison of clinical features, laboratory findings, and clinical outcomes in patients hospitalized at Alessandria’s General Hospital","authors":"Iacopo Megna, S. Penpa, A. Cassinari, Christian Leli, Andrea Rocchetti, A. Roveta, Marta Betti, A. Maconi","doi":"10.4081/wpph.2023.9809","DOIUrl":"https://doi.org/10.4081/wpph.2023.9809","url":null,"abstract":"Aims: the aim of the present study was to compare the clinical, anamnestic, and laboratory features and outcomes of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pneumonia and pneumonia caused by Streptococcus pneumoniae in hospitalized patients at the General Hospital of Alessandria, Italy. Materials and Methods: radiological diagnosis of pneumonia by chest X-ray and/or chest Computed Tomography (CT); microbiological diagnosis of SARS-CoV-2 infection by nasopharyngeal swab Reverse Transcriptase - Polymerase Chain Reaction (RT-PCR), etiological diagnosis of S. pneumoniae pneumonia by positive urinary antigen detection and/or isolation of S. pneumoniae from respiratory and/or blood cultures. Results: 222 patients were included, 171 with SARS-CoV-2 pneumonia and 51 with S. pneumoniae. SARS-CoV-2 group most frequently treated with antiviral drugs: 139/171 (81.3%) vs 1/51 (2.1%); p<0.001; they often needed oxygen therapy: 142/171 (83%) vs 27/51 (56.3%); p<0,001; and non-invasive mechanical ventilation: 59/171 (34.5%) vs 7/51 (14.6%); p=0.004. Mortality was higher in SARS-CoV-2 pneumonia patients: 46/171 (26.9%) than in pneumococcal pneumonia patients 5/51 (9.8%); p=0.011. Conclusions: the study showed the increased prevalence of pneumonia caused by SARS-CoV-2 and S. pneumoniae in males than in females. Moreover, patients with SARS-CoV-2 pneumonia represent higher risk group for complications and death than S. pneumoniae.","PeriodicalId":489652,"journal":{"name":"Working paper of public health","volume":"121 34","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139614908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of clinical and laboratory data to estimate the probability of bacterial diarrhea diagnosed by stool multiplex Polymerase Chain Reaction assay in a pediatric population","authors":"Christian Leli, Valentina Pizzo, Marcella Cerrato, Salvatore Castaldo, A. Roveta, M.M Ciriello, Enrico Felici, A. Maconi, Andrea Rocchetti","doi":"10.4081/wpph.2023.9842","DOIUrl":"https://doi.org/10.4081/wpph.2023.9842","url":null,"abstract":"Aims: we estimated the probability of a positive result for the most common bacterial causal agents of diarrhea, such as Campylobacter spp., Salmonella spp., Shigella/Enteroinvasive Escherichia coli, Yersinia enterocolitica or Shiga toxin-producing Escherichia coli by a stool multiplex Polymerase Chain Reaction (PCR) assay in a pediatric population evaluated at the Pediatric and Pediatric Emergency Unit, Children Hospital of the Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy, during the period April 2022 - July 2023. Methods: we analyzed the clinical data collected by the Pediatrician on the stool sample request form along with complete blood count and C-Reactive Protein (CRP). Results: in our case series, the presence of blood/mucus in stool along with an increased value of CRP are independently associated with a positive result diagnosed by molecular method for bacterial diarrhea caused by the aforementioned pathogens. Conclusions: the results proposed in this paper can be of help in hospital settings without the availability of a stool multiplex PCR assay to estimate the probability of bacterial diarrhea in a pediatric patient.","PeriodicalId":489652,"journal":{"name":"Working paper of public health","volume":"12 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139443390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of lymphocyte subsets in COVID-19 patients: a retrospective observational study","authors":"M.M Ciriello, Nicoletta Tommasi, Costanza Massarino, A. Cassinari, T. Bensi, Raffaella Doglio, A. Roveta, A. Maconi","doi":"10.4081/wpph.2023.9643","DOIUrl":"https://doi.org/10.4081/wpph.2023.9643","url":null,"abstract":"In this retrospective study, we analyzed the possible predictive changes in lymphocyte subsets of Coronavirus Disease 19 (COVID-19) hospitalized patients. We enrolled 107 COVID-19 patients older than 18 years of age, admitted to Alessandria Hospital with a confirmed diagnosis of SARS-CoV-2 infection by Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR), who performed the analysis of lymphocyte subsets, between 2020 March 01 and 2021 May 31. Patients have been split up into two groups, based on clinical manifestations: group 1 non-severe disease (n=44) and group 2 severe disease (n=63), according to the World Health Organization (WHO) interim guidance. For the comparison between the two groups of patients, statistical significance was tested with the Mann-Whitney and the Chi-Square test. In the group of patients with severe disease, the blood cell analysis showed a significant reduction in the counts of total lymphocytes, absolute CD3 lymphocytes, and CD8 lymphocytes, as well as a significant reduction in monocyte percent and a very significant increase in neutrophil counts. From the results obtained, it can be stated that lymphocytopenia is associated with the progression of the disease and increased mortality.","PeriodicalId":489652,"journal":{"name":"Working paper of public health","volume":" 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138963765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A review on Interstitial Lung Diseases: an overview from diagnosis to innovative therapies","authors":"Carlotta Bertolina, Marinella Bertolotti, Marianna Farotto, Fabio Giacchero, Silvia Ravera, Mario Salio, Mercedes Pasquali, Antonio Maconi","doi":"10.4081/wpph.2023.9785","DOIUrl":"https://doi.org/10.4081/wpph.2023.9785","url":null,"abstract":"Interstitial Lung Diseases (ILDs) enclose a wide heterogeneous group of more than 200 pathological disorders, which are characterized by an inflammatory and/or fibrotic pattern in the respiratory tract. In recent years, significant developments in the understanding of their pathogenesis have led to considerable progress in the therapeutic field and in improving clinical outcomes. COVID-19 pandemic has also had an important impact on the course of interstitial disease, particularly that which developed following infection in both symptomatic and asymptomatic patients, as well as in patients with pre-existing interstitial disease prior to infection. The purpose of this review is to describe clinical, radiological and therapeutic features of some of the most common interstitial lung diseases, as well as the multidisciplinary diagnostic procedure that underlies an increasingly accurate diagnosis.","PeriodicalId":489652,"journal":{"name":"Working paper of public health","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135246717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of a questionnaire on asbestos awareness among students: a pilot study","authors":"Adriana Canepa, Carlo Degiacomi, Maria Cristina Portinaro, Grazia Gatti, Stefania Crivellari, Carlotta Bertolina, Marianna Farotto, Melissa Pozzi, Leonardo Deambrogio, Riccardo Belvisotti, Marinella Bertolotti, Antonio Maconi","doi":"10.4081/wpph.2023.9783","DOIUrl":"https://doi.org/10.4081/wpph.2023.9783","url":null,"abstract":"Background: there is no resolutive treatment for asbestos-related diseases, but prevention plays a key role. This survey was conducted to test the feasibility of a questionnaire to measure the awareness on asbestos among the students in a specific asbestos polluted area. Furthermore, we carried out a preliminary assessment of student awareness on this topic. Methods: a questionnaire was used among secondary school students of Casale Monferrato. This considered the levels of sensitivity, knowledge, and experienced emotions. Results: 788 students completed the questionnaire out of a total of 3600 (22.2%). Thirty-five percent of the students were poorly informed about the asbestos issue, 26% felt that they had basic information on this topic. Twelve percent of the students thought that asbestos is no longer a problem. Conclusions: it emerges the strong need to become more knowledgeable on asbestos’ history. A questionnaire is a useful tool, but structural changes are needed to facilitate the analysis of the results.","PeriodicalId":489652,"journal":{"name":"Working paper of public health","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135016087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}