Recenti progressi in medicina最新文献

In urban areas, environmental exposures to air pollution, extreme temperatures and noise as well as socio-economic inequalities are amplified. Urban green spaces offer dual benefits: they help mitigate climate change and improve public health by fostering connection to nature, reducing noise and air pollution, mitigating the urban heat island effect, and promoting physical activity. Within the 2023 "Cobenefici di Salute ed equità a supporto dei piani di risposta ai cambiamenti climatici in Italia" project funded by the Ministry of Health, we identified health indicators to assess climate action co-benefits, including those on cardiovascular disease mortality and morbidity, birth outcomes and mental health. An increase of 0.1 in the Normalized Difference Vegetation Index (NDVI) was found to be associated with a 3% reduction in cardiovascular mortality rates (95% CI: -4% to -1%). Such estimates will be applied in health impact assessment studies to help guide effective climate adaptation and public health strategies.

The role of Real-World Evidence (RWE) concerns the entire drug lifecycle; despite widely recognised in the post-marketing, it is still debated in the pre-marketing, mainly as per the identification and analysis of target populations (TPs) for new drugs or indications. Through administrative healthcare databases, Research and Health Foundation (ReS), in collaboration with experts, develops algorithms to select and analyse TPs. As of March 2024, 85 TPs in 15 clinical areas have been analysed, of which oncology is the most represented. Findings on prevalence and incidence of specific diseases (or subpopulations), patient characteristics and costs directly charged to the Italian National Health Service, are provided. These are useful for healthcare institutions and pharmaceutical companies. In the future, efforts will focus on the development of tools based on artificial intelligence and synthetic data to improve analyses of TPs and support regulatory decisions on drugs.

Informed consent is mandatory for an individual to receive a clinical service, yet the process is often still tough and twisty. This is a hot topic also for patient associations and thus PaLiNUro associaton set the objective to produce, with a multidisciplinary approach, a simple but comprehensive information note to the informed consent for people with urothelial cancer about to undergo to a radical cystectomy surgery. After assessing as not valid 12 information notes from nine Italian hospitals, the multidisciplinary group produced an eight-page document accompanied by a supplemental document for further details, both available on PaLiNUro website.

The data from recent years on chronic disease mortality in Rome's V district show a significant disparity compared to the city's central neighborhoods, with a 23% increase in chronic diseases and an 80% rise in diabetes cases. The 'Ambulatorio Popolare Roma Est', an autonomous healthcare facility founded in 2022 in Quarticciolo neighborhood, is run by over 30 volunteers, including medical specialists, therapists, nutritionists and students. The clinic provides free services such as medical consultations, psychological support and nutritional advice. Its goals are to improve access to healthcare, advocate for institutional support and empower the community through health education and social determinants. In 2023, 205 medical consultations were conducted with 55 new patients, mostly aged 60-75. Many faced obstacles like long wait times in National health service, denied appointments or lack of information in access the public system. The clinic emphasizes that the growing health needs in this area are being systematically ignored, leading to further health inequities in an already socially deprived neighborhood.

This analysis aims to describe the care pathways of patients with central nervous system (Cns) tumors during the last 30 days of life, using relevant indicators retrieved from regional healthcare information system data, compare these indicators with those of patients who died from other solid tumors, and assess the role of socioeconomic position (Sep) in accessing end-of-life care among Cns patients. The study included 2,795 patients who died from Cns tumors between 2015 and 2019. In the last 30 days of life, compared to the solid tumor cohort, Cns patients had less access to emergency services and hospitalizations. Regarding treatments, the percentage of opioid users was significantly lower than that of solid tumor patients. Concerning the role of Sep, Cns patients with a higher Sep were less likely to access the Emergency Room and more likely to receive antitumor. In conclusion, the analysis of administrative databases in epidemiology is essential in order to monitor care pathways targeted at highly vulnerable populations.

Objectives: To assess the safety profile of dietary supplements with a focus on those purchased online or reported via the internet.

Results: Among the 2,367 reports of Adverse Reactions (ARs) to dietary supplements collected within the Italian Phitovigilance System, 49.4% were from citizens and 33.7% from companies. From these we selected 129 reports (6%) in which an online purchase or an adverse reaction retrieved from the web was indicated (e.g. Amazon®). The most frequent ARs referred to the gastrointestinal tract (31.4%) and the central nervous system (17.6%). Nineteen percent were used for sleep disorders and 14% for disturbances of the prostate.

Conclusions: The Italian Phytovigilance System is the only tool that provides information on the possible risks associated with the use of food supplements purchased online but the quality of the information collected needs to be improved.

Recently, talking about abortion, the Pope has spoken harshly regarding the role played by non-objecting doctors. The article discusses: 1) the ethical and health aspects that the denial of the right to terminate pregnancy entails; 2) the positive results obtained by non-objecting doctors 50 years after the implementation of Law no. 194/1978, in terms of safeguarding women's health and guaranteeing the implementation of a state law.

Introduction: The availability of epidemiological data relating to the therapy with somatropin (recombinant Growth Hormone, rGH) is scarce and mostly limited to specific clinical conditions. In Italy, the National Register of rGH users (Registro nazionale degli assuntori dell'ormone della crescita - Rnaoc) has been established since 2004 as recommended by the Italian medicine agency (Aifa). However, prevalence (P) and incidence (I) estimates in the Italian population are lacking.

Methods: Data from the Rnaoc and a questionnaire submitted to all the Italian regions have been used to calculate P and I rates of rGH treatment exposure in the Italian paediatric (0-17 years) and adult (≥18 years) population during 2019-2022; P and I rates of growth hormone deficiency (GHD) in paediatric patients have been estimated as well. Results from the two data sources have been compared.

Results: In 2019-2022, the estimated P rate in the paediatric population was 13,4/10.000, in adults 0,7/10.000 inhabitants; the I rate was 2,3/10.000 and 0,06/10.000 inhabitants, correspondingly. The estimated P rate of paediatric GHD was 8,9/10.000, the I rate was 1,5/10.000 inhabitants, respectively.

Conclusion: Study results showed a better reliability of data collected via questionnaire because more consistent with Italian regional resident populations.