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COVID-19 vaccination in nursing homes: considerations on freedom to make decisions and legal protection measures 疗养院COVID-19疫苗接种:对决策自由和法律保护措施的考虑
IF 0.4 Q4 Medicine Pub Date : 2022-05-01 DOI: 10.36150/2499-6564-n496
P. Delbon, E. Buzzi, F. Maghin, A. Bianchetti, A. Conti
In the most vulnerable people, especially among the elderly, the COVID-19 pandemic has brought to light complex ethical issues such as consent to receive health care, the relationship between risks and benefits of therapies, the choices to be made during the most serious phases of the disease and family relationships have been made ex-treme and heavily emphasized by the pandemic. The article analyzes the ethical and legal aspects of the problem of reconciling respect for the individual’s right to make their own decisions and the need to protect the most vulnerable and fragile sections of the population (the dilemma between the principle of charity and respect for autonomy), with all the related communication, procedural and legal problems relating to Informed Consent. The exceptional circumstances of the pandemic have prompted law-makers to tackle the complex and long-neglected issue of the consent of vulnerable, generally elderly, individuals. In many contexts, from home to hospital to nursing home, patient in-volvement in decision making, the role of the family, and procedures for defining competencies above and beyond diagnostic categories, continue to be largely left behind. part in the hands of the health care workers or team. The methods chosen to obtain consent to vaccina-tion, together with the provisions of the Law of 22 December 2017 on the role of the trustee, pave the way for more appropriate operating methods for daily clinical practice in the field. © by Società Italiana di Gerontologia e Geriatria (SIGG).
在最脆弱的人群中,特别是在老年人中,2019冠状病毒病大流行暴露了复杂的伦理问题,如接受医疗保健的同意、治疗的风险与益处之间的关系、在疾病最严重阶段要做出的选择,以及家庭关系,这些问题都因大流行而变得极端和严重。这篇文章分析了伦理和法律方面的问题,调和尊重个人的权利作出自己的决定和需要保护人口中最脆弱和最脆弱的部分(慈善原则和尊重自治之间的困境),所有相关的沟通,程序和法律问题与知情同意。这种流行病的特殊情况促使立法者解决长期被忽视的复杂问题,即弱势群体(通常是老年人)的同意。在许多情况下,从家庭到医院到养老院,病人参与决策、家庭的作用以及确定诊断类别以外的能力的程序,在很大程度上仍然被抛在后面。部分在卫生保健工作者或团队手中。所选择的获得疫苗接种同意的方法,以及2017年12月22日关于受托人作用的法律的规定,为现场日常临床实践中更合适的操作方法铺平了道路。©意大利老年医学协会(SIGG)。
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引用次数: 0
Toll-like receptor 4 and the inflammation during aging toll样受体4与衰老过程中的炎症
IF 0.4 Q4 Medicine Pub Date : 2022-03-01 DOI: 10.36150/2499-6564-n471
Aliakbar Yousefi-Ahmadipour, Mohadeseh Sartipi, H. Khodadadi, Mehdi Shariati-Kohbanani, M. Arababadi
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引用次数: 0
Italian long-term care facilities during COVID-19 era: a review 新冠肺炎时代的意大利长期护理机构:回顾
IF 0.4 Q4 Medicine Pub Date : 2022-03-01 DOI: 10.36150/2499-6564-n365
R. Gnasso, I. Iommazzo, G. Corbi, Francesco S Celi, A. Iannicelli, Nicola Ferrara, C. Ruosi
Background. Since the start COVID-19 epidemic, 9154 deaths have been registered in Italian Long-Term Care Facilities (LTCF). Half of them were COVID 19-related. Objective. In this review we analyzed the management of COVID-19 outbreak in Italian LTCF, in the most affected regions. Results. In the Italian Institute of Health (ISS) report, 1356 LTCF (41.3%) answered to questionnaires on COVID-19 infection in LTCF. Only 7.4% of deaths was related to Coronavirus (confirmed by swab), while 33,8% of deceased presented flu-like symptoms without confirmation by swab. 77.2% of structures reported the lack of Personal Protective Equipment. The autonomous management policies of the regions cannot be negligible in this assessment, above all Lombardia Region that diverted patients from hospital to extra-structures, like LTCF. Conclusions. The elderlies represent high-risk patients for developing COVID-19 with rapid clinical deterioration. Containment measures should be particularly optimized, especially in anticipation of another possible pandemic recurrence. Surely a comparison among different systems could help to achieve more information in the standardization of procedures. Identifying flaws in this system is necessary to perfect and optimize epidemic management as much as possible. © by Società Italiana.
背景。自COVID-19开始流行以来,意大利长期护理机构(LTCF)已登记了9154例死亡病例。其中一半与COVID - 19有关。目标。在本综述中,我们分析了意大利LTCF中受影响最严重地区的COVID-19疫情管理情况。结果。在意大利卫生研究所(ISS)的报告中,1356名LTCF(41.3%)回答了LTCF中COVID-19感染的问卷。只有7.4%的死亡与冠状病毒有关(通过拭子确诊),而33.8%的死者出现流感样症状,但没有通过拭子确诊。77.2%的建筑缺乏个人防护装备。在这一评估中,各地区的自治管理政策不容忽视,尤其是伦巴第大区,它将病人从医院转移到其他机构,如LTCF。结论。老年人是新冠肺炎发病的高危人群,临床恶化迅速。应特别优化控制措施,特别是在预计可能再次出现大流行的情况下。当然,在不同制度之间进行比较有助于在程序标准化方面获得更多的信息。找出这一制度的缺陷,是尽可能完善和优化疫情管理的必要条件。©by societ Italiana。
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引用次数: 2
Dyspnea as a symptom of progressive chronic myeloproliferative disease: a rare case of hemorrhagic alveolitis and pulmonary fibrosis, due to extramedullary erythropoiesis 呼吸困难作为进行性慢性骨髓增生性疾病的症状:髓外红细胞生成引起出血性肺泡炎和肺纤维化的罕见病例
IF 0.4 Q4 Medicine Pub Date : 2022-03-01 DOI: 10.36150/2499-6564-n479
C. Frangi, S. Damanti, E. Bozzolo, R. Scotti, G. Di Lucca, M. Tresoldi
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引用次数: 0
Computer-aided cognitive training in patients with neurocognitive vascular impairment: effects on cognition, depression and behavior 神经认知血管损伤患者的计算机辅助认知训练:对认知、抑郁和行为的影响
IF 0.4 Q4 Medicine Pub Date : 2022-03-01 DOI: 10.36150/2499-6564-n357
S. Vaia, A. Iavarone, F. Moschiano, Carlo Strube, N. Gamboz, G. De Pietro, S. Gentile, E. Garofalo, M. Sannino, Michele Carpinelli Mazzi
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引用次数: 0
The GLP-1 receptor agonist Exendin-4 modulates hippocampal NMDA-receptor signalling in aged rats and improves cognitive impairment in diabetic elderly patients GLP-1受体激动剂Exendin-4调节老年大鼠海马nmda受体信号传导,改善老年糖尿病患者认知功能障碍
IF 0.4 Q4 Medicine Pub Date : 2022-03-01 DOI: 10.36150/2499-6564-n474
A. Romano, Rosanna Villani, M. Sangineto, T. Cassano, G. Serviddio
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引用次数: 0
Depressive symptoms and cognitive/functional status in a sample of elderly subjects referring to a memory clinic 参考记忆诊所的老年受试者样本的抑郁症状和认知/功能状态
IF 0.4 Q4 Medicine Pub Date : 2022-03-01 DOI: 10.36150/2499-6564-n382
L. Marabini, Chiara Pazzaglini, Stefania Bonazzi, Patrizia Guasti, G. Guerra, A. Zurlo, G. Zuliani, G. Brombo
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引用次数: 0
Models of hospital care during COVID-19 pandemic in Italy: results from a survey of physicians 意大利新冠肺炎大流行期间的医院护理模式:对医生的调查结果
IF 0.4 Q4 Medicine Pub Date : 2022-03-01 DOI: 10.36150/2499-6564-n377
A. Bellieni, R. Liperoti, C. Pais, R. Murri, R. Bernabei, M. Fantoni, F. Landi
During COVID-19 pandemic, COVID Hospitals were created throughout Italy and several different models of care for COVID-19 patients were implemented. Methods. We conducted a survey on physicians dedicated to the care of COVID-19 patients with the aim of describing specific models of hospital care that were implemented during the first wave of the pandemic in Italy. The survey included seven questions with an estimated response time of approximately 5 minutes. The questionnaire went through a face validation process and pilot testing. The final version of the questionnaire was disseminated through a national limited social platform for physicians involved in the care of COVID-19 patients. Results. In the time period between May 1st, 2020 and July 1st, 2020, 350 physicians from all over the Country participated to the survey. In most cases, old departments were transformed to COVID units, and new units dedicated to COVID-19 patients were created. A multidisciplinary team of specialists was available in half of the models of care described. The geriatrician was always part of the mulridisciplinary team. Over one third of the multidisciplinary teams for the care of COVID-19 patients also included infectious diseases specialists and pulmonologists. Conclusions. According to findings from our survey, co-management of care and multidisciplinary models were available for half of COVID-19 patients during the first wave of pandemic. Such models may offer significant advantages in terms of favourable outcomes and mortality, especially in complex older adults. © by Società Italiana di Gerontologia e Geriatria (SIGG).
在新冠肺炎大流行期间,意大利各地建立了新冠肺炎医院,并为新冠肺炎患者实施了几种不同的护理模式。方法。我们对专门护理新冠肺炎患者的医生进行了一项调查,目的是描述意大利第一波疫情期间实施的具体医院护理模式。调查包括七个问题,预计回答时间约为5分钟。调查问卷经过了人脸验证和试点测试。调查问卷的最终版本是通过一个全国有限的社交平台为参与新冠肺炎患者护理的医生分发的。后果在2020年5月1日至2020年7月1日期间,来自全国各地的350名医生参加了调查。在大多数情况下,旧部门被改造为新冠肺炎单位,并创建了专门用于新冠肺炎患者的新单位。在所描述的一半护理模式中,有一个多学科专家团队。老人科医生一直是多学科团队的一员。新冠肺炎患者护理多学科团队中,超过三分之一还包括传染病专家和肺科医生。结论。根据我们的调查结果,在第一波疫情期间,有一半的新冠肺炎患者可以使用共同护理管理和多学科模式。这种模式可能在有利的结果和死亡率方面具有显著优势,尤其是在复杂的老年人中。©意大利老年医学协会(SIGG)。
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引用次数: 1
Understanding of frailty amid Japanese elderly people who participated in preventive care events and characteristics of those lacking understanding of frailty 参加预防保健活动的日本老年人对虚弱的认识及对虚弱缺乏认识的老年人的特点
IF 0.4 Q4 Medicine Pub Date : 2022-03-01 DOI: 10.36150/2499-6564-n414
M. Karasawa, Y. Tamaura, R. Akamatsu, Masumi Eda, Himawari Fukasawa, Miki Hokazono, Saya Watanabe, K. Fujiwara, Kazuhiro Nishimura, M. Sakai
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引用次数: 0
Prescribing, monitoring, and deprescribing drugs in geriatric DM patients 老年糖尿病患者的处方、监测和解除处方
IF 0.4 Q4 Medicine Pub Date : 2021-12-01 DOI: 10.36150/2499-6564-n459
E. Mannucci
This is an open access article distributed in accordance with the CC-BY-NC-ND (Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International) license. The article can be used by giving appropriate credit and mentioning the license, but only for non-commercial purposes and only in the original version. For further information: https://creativecommons.org/licenses/by-nc-nd/4.0/deed.en CliniCal GeriatriCs reviews
这是一篇根据CC-BY-NC-ND(Creative Commons Attribution NonCommercial NoDerivatives 4.0 International)许可证分发的开放获取文章。文章可以通过给予适当的信用和提及许可证来使用,但只能用于非商业目的,并且只能在原始版本中使用。欲了解更多信息:https://creativecommons.org/licenses/by-nc-nd/4.0/deed.enCliniCal老年医学评论
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引用次数: 1
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Journal of Gerontology and Geriatrics
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