F. Pietrantonio, F. Rosiello, Matteo Ruggeri, M. S. Cattaruzza, Antonio Vinci, Margherita Lordi, Enrica Cipriano
COVID-19 represents a threat for frailty patients. This study compares molnupiravir and nirmatrelvir for fragile COVID- 19 patients' efficacy, safety, and cost. An observational, prospective study allowed us to evaluate molnupiravir’s efficacy and safety in real life, compare it to a subgroup of patients treated with nirmatrelvir-ritonavir, and analyze its cost-effectiveness. From January to December 2022, 435 patients (225 males, 220 females; median age 72 years), were enrolled; 24 patients were unvaccinated, and 280 patients had ≥2 risk factors. Molnupiravir performed better clinically and economically. Compared to literature data, in these patients, hospitalization was 2.5% vs. 6.8% (P<0.005), overall adverse effects 14,3% vs. 30.4% (P<0.0001), severe adverse effects 2.6 vs. 6.9% (P<0.001), thus involving potential total savings of about € 92.954 per patient (8% of standard of care cost). Early molnupiravir treatment helped fragile patients who partially responded to the vaccine, or with absolute contraindications to vaccination, to overcome COVID-19 without the need for hospitalization. In elderly patients with multiple pathologies and multiple drugs, molnupiravir prevents disease progression clinically and economically.
{"title":"Prevention is better than healing. Clinical and economic implications of oral antiviral agents in COVID-19: a prospective study","authors":"F. Pietrantonio, F. Rosiello, Matteo Ruggeri, M. S. Cattaruzza, Antonio Vinci, Margherita Lordi, Enrica Cipriano","doi":"10.4081/itjm.2024.1737","DOIUrl":"https://doi.org/10.4081/itjm.2024.1737","url":null,"abstract":"COVID-19 represents a threat for frailty patients. This study compares molnupiravir and nirmatrelvir for fragile COVID- 19 patients' efficacy, safety, and cost. An observational, prospective study allowed us to evaluate molnupiravir’s efficacy and safety in real life, compare it to a subgroup of patients treated with nirmatrelvir-ritonavir, and analyze its cost-effectiveness. From January to December 2022, 435 patients (225 males, 220 females; median age 72 years), were enrolled; 24 patients were unvaccinated, and 280 patients had ≥2 risk factors. Molnupiravir performed better clinically and economically. Compared to literature data, in these patients, hospitalization was 2.5% vs. 6.8% (P<0.005), overall adverse effects 14,3% vs. 30.4% (P<0.0001), severe adverse effects 2.6 vs. 6.9% (P<0.001), thus involving potential total savings of about € 92.954 per patient (8% of standard of care cost). Early molnupiravir treatment helped fragile patients who partially responded to the vaccine, or with absolute contraindications to vaccination, to overcome COVID-19 without the need for hospitalization. In elderly patients with multiple pathologies and multiple drugs, molnupiravir prevents disease progression clinically and economically.","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141271917","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}
Huu Cong Nguyen, Hung Quoc Doan, L. Ngo, U. H. Nguyen, Long Hoang Vo, Thanh Ngoc Le
We examined the technique and early outcomes of coronary artery bypass graft surgery (CABG) with endarterectomy. In 2023, the single-center database identified 24 severe coronary disease patients undergoing CABG with coronary artery endarterectomy. The patients were in a selected cohort with a minimum of three grafts for the three main vessels. Patients’ mean age was 63.8 years. The mean number of grafts was 4.3. A coronary endarterectomy (CE) was performed on the right coronary artery in 45.8% of patients, the left anterior descending artery in 29.1%, the circumflex artery in 16.6%, and the diagonal artery in 29.1%. Aortic cross-clamp took 147.2 minutes, perfusion 180.9 minutes, mechanical ventilation 18.9 hours, and intensive care unit stay 4.8 days. Our in-hospital mortality rate was 8.3% with no technical complications. To achieve complete revascularization in patients with extensive coronary artery disease, CE should be considered an acceptable adjunct to CABG.
{"title":"Complete revascularization in coronary artery bypass grafting with coronary artery endarterectomy: updated findings from Vietnam","authors":"Huu Cong Nguyen, Hung Quoc Doan, L. Ngo, U. H. Nguyen, Long Hoang Vo, Thanh Ngoc Le","doi":"10.4081/itjm.2024.1734","DOIUrl":"https://doi.org/10.4081/itjm.2024.1734","url":null,"abstract":"We examined the technique and early outcomes of coronary artery bypass graft surgery (CABG) with endarterectomy. In 2023, the single-center database identified 24 severe coronary disease patients undergoing CABG with coronary artery endarterectomy. The patients were in a selected cohort with a minimum of three grafts for the three main vessels. Patients’ mean age was 63.8 years. The mean number of grafts was 4.3. A coronary endarterectomy (CE) was performed on the right coronary artery in 45.8% of patients, the left anterior descending artery in 29.1%, the circumflex artery in 16.6%, and the diagonal artery in 29.1%. Aortic cross-clamp took 147.2 minutes, perfusion 180.9 minutes, mechanical ventilation 18.9 hours, and intensive care unit stay 4.8 days. Our in-hospital mortality rate was 8.3% with no technical complications. To achieve complete revascularization in patients with extensive coronary artery disease, CE should be considered an acceptable adjunct to CABG.","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141098739","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}
Karim Ouali, Btihaj AL Ibrahmi, Said Bouchefra, Abdellatif Bour
Worldwide, millions of people suffer from diabetes. Our study aimed to describe the sample’s weight status and the effects of providing individualized micronutrient prescriptions and nutritional counseling to individuals with diabetes. Of the 46 patients (26 women and 20 men) enrolled in this study between 2014 and 2021, 41% had insulin-resistant diabetes and were over the age of 18. In compliance with the World Health Organization guidelines, anthropometric measurements were taken. The impedencemeter was used to measure the visceral fat. Diabetes affected 41% of the patients, with women making up the majority (74%). An impedencemeter’s average measurement of 6 for visceral fat loss was encouraging, and a glycated hemoglobin analysis of diabetics revealed an average loss of 1.6%. A good sign for lowering the therapeutic load is that 16% of diabetic patients were able to stop taking any medication at all, and 79% of patients were able to reduce their dosage. This study served as a strong foundation for the creation of customized nutritional management programs in Morocco to enhance the metabolic health of patients who are obese and insulin-resistant.
{"title":"Micronutrition and diabetes: a new view at prevention and treatment","authors":"Karim Ouali, Btihaj AL Ibrahmi, Said Bouchefra, Abdellatif Bour","doi":"10.4081/itjm.2024.1728","DOIUrl":"https://doi.org/10.4081/itjm.2024.1728","url":null,"abstract":"Worldwide, millions of people suffer from diabetes. Our study aimed to describe the sample’s weight status and the effects of providing individualized micronutrient prescriptions and nutritional counseling to individuals with diabetes. Of the 46 patients (26 women and 20 men) enrolled in this study between 2014 and 2021, 41% had insulin-resistant diabetes and were over the age of 18. In compliance with the World Health Organization guidelines, anthropometric measurements were taken. The impedencemeter was used to measure the visceral fat. Diabetes affected 41% of the patients, with women making up the majority (74%). An impedencemeter’s average measurement of 6 for visceral fat loss was encouraging, and a glycated hemoglobin analysis of diabetics revealed an average loss of 1.6%. A good sign for lowering the therapeutic load is that 16% of diabetic patients were able to stop taking any medication at all, and 79% of patients were able to reduce their dosage. This study served as a strong foundation for the creation of customized nutritional management programs in Morocco to enhance the metabolic health of patients who are obese and insulin-resistant.","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141102198","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}
A new and powerful selective xanthine oxidase inhibitor called febuxostat seems to be well tolerated by all patient populations, even those who are allopurinol-sensitive. Thrombocytopenia is an extremely uncommon side effect. The case of a 63- year-old man who presented with sudden thrombocytopenia and was ultimately linked to febuxostat consumption is described below. The case happened in our department.
{"title":"A rare case of thrombocytopenia secondary to taking febuxostat","authors":"Isabella Di Zio, Rodolfo Cisternino","doi":"10.4081/itjm.2024.1724","DOIUrl":"https://doi.org/10.4081/itjm.2024.1724","url":null,"abstract":"A new and powerful selective xanthine oxidase inhibitor called febuxostat seems to be well tolerated by all patient populations, even those who are allopurinol-sensitive. Thrombocytopenia is an extremely uncommon side effect. The case of a 63- year-old man who presented with sudden thrombocytopenia and was ultimately linked to febuxostat consumption is described below. The case happened in our department.","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2024-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140666244","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}
The identification of patients with poor prognosis and early detection of COVID-19 disease complications are made possible by pathological analyses of routine hematological, coagulation, and biochemical tests. Interpreting analyses needs to be done within the framework of each patient’s unique clinical picture. It’s also critical to keep an eye on changes at the individual parameter level. From May 20th, 2021, to March 30th, 2024, a comprehensive search of literature was carried out using international databases, such as PubMed, Embase, Web of Science, Scopus, and the Cochrane Library, in compliance with the PRISMA guidelines. The research question was formulated using the PICO strategy. The following terms were used: biochemical parameters in COVID-19, hematological parameters in COVID-19, blood coagulation parameters in COVID-19, indicators of inflammation, and indicators of tissue damage in SARS-CoV-2. Routine hematological, coagulation, and biochemical tests are primarily used to monitor the progression of the disease and the effectiveness of treatment rather than being utilized for the established diagnosis of COVID-19 due to their low specificity. Molecular genetics and immunological techniques should be used to determine the COVID-19 disease diagnosis.
{"title":"Pathological changes of biochemical, hematological and coagulation analyses in patients with COVID-19 disease","authors":"Zafer Gashi, Muhamet Kadrija","doi":"10.4081/itjm.2024.1723","DOIUrl":"https://doi.org/10.4081/itjm.2024.1723","url":null,"abstract":"The identification of patients with poor prognosis and early detection of COVID-19 disease complications are made possible by pathological analyses of routine hematological, coagulation, and biochemical tests. Interpreting analyses needs to be done within the framework of each patient’s unique clinical picture. It’s also critical to keep an eye on changes at the individual parameter level. From May 20th, 2021, to March 30th, 2024, a comprehensive search of literature was carried out using international databases, such as PubMed, Embase, Web of Science, Scopus, and the Cochrane Library, in compliance with the PRISMA guidelines. The research question was formulated using the PICO strategy. The following terms were used: biochemical parameters in COVID-19, hematological parameters in COVID-19, blood coagulation parameters in COVID-19, indicators of inflammation, and indicators of tissue damage in SARS-CoV-2. Routine hematological, coagulation, and biochemical tests are primarily used to monitor the progression of the disease and the effectiveness of treatment rather than being utilized for the established diagnosis of COVID-19 due to their low specificity. Molecular genetics and immunological techniques should be used to determine the COVID-19 disease diagnosis.","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140672439","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}
In hospital settings, effective risk management is critical to ensuring patient safety, regulatory compliance, and operational effectiveness. Conventional approaches to risk assessment and mitigation frequently rely on manual procedures and retroactive analysis, which might not be sufficient to recognize and respond to new risks as they arise. This study examines how artificial intelligence (AI) technologies can improve risk management procedures in healthcare facilities, fortifying patient safety precautions and guidelines while improving the standard of care overall. Hospitals can proactively identify and mitigate risks, optimize resource allocation, and improve clinical outcomes by utilizing AI-driven predictive analytics, natural language processing, and machine learning algorithms. The different applications of AI in risk management are discussed in this paper, along with opportunities, problems, and suggestions for their effective use in hospital settings.
{"title":"Enhancing risk management in hospitals: leveraging artificial intelligence for improved outcomes","authors":"Ranieri Guerra","doi":"10.4081/itjm.2024.1721","DOIUrl":"https://doi.org/10.4081/itjm.2024.1721","url":null,"abstract":"In hospital settings, effective risk management is critical to ensuring patient safety, regulatory compliance, and operational effectiveness. Conventional approaches to risk assessment and mitigation frequently rely on manual procedures and retroactive analysis, which might not be sufficient to recognize and respond to new risks as they arise. This study examines how artificial intelligence (AI) technologies can improve risk management procedures in healthcare facilities, fortifying patient safety precautions and guidelines while improving the standard of care overall. Hospitals can proactively identify and mitigate risks, optimize resource allocation, and improve clinical outcomes by utilizing AI-driven predictive analytics, natural language processing, and machine learning algorithms. The different applications of AI in risk management are discussed in this paper, along with opportunities, problems, and suggestions for their effective use in hospital settings.","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140703065","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}
A. Pizzini, C. Fantoni, S. Zaccaroni, Mauro Silingardi
Because there is little clinical experience with apixaban in patients with severe renal impairment and non-valvular atrial fibrillation, the European Medicines Agency does not advise using it to prevent strokes in these patients. However, only a small number of pharmacokinetic and pharmacodynamic investigations showed how crucially different elimination pathways contribute to the clearance of apixaban. A 74-year-old male patient who was receiving apixaban treatment for stroke prevention in atrial fibrillation was referred to our hospital because of acute severe renal failure brought on by dehydration and abnormally elevated apixaban plasma levels. The patient was treated only with intravenous fluid therapy; serum creatinine recovered slowly over the course of six days, but plasma apixaban levels recovered quickly. No bleeding events have been recorded. Our experience demonstrates the safety profile of apixaban in cases of severe renal failure, but it also emphasizes the need for more research to confirm this evidence.
{"title":"Acute severe renal failure in a patient receiving apixaban: a case report","authors":"A. Pizzini, C. Fantoni, S. Zaccaroni, Mauro Silingardi","doi":"10.4081/itjm.2024.1718","DOIUrl":"https://doi.org/10.4081/itjm.2024.1718","url":null,"abstract":"Because there is little clinical experience with apixaban in patients with severe renal impairment and non-valvular atrial fibrillation, the European Medicines Agency does not advise using it to prevent strokes in these patients. However, only a small number of pharmacokinetic and pharmacodynamic investigations showed how crucially different elimination pathways contribute to the clearance of apixaban. A 74-year-old male patient who was receiving apixaban treatment for stroke prevention in atrial fibrillation was referred to our hospital because of acute severe renal failure brought on by dehydration and abnormally elevated apixaban plasma levels. The patient was treated only with intravenous fluid therapy; serum creatinine recovered slowly over the course of six days, but plasma apixaban levels recovered quickly. No bleeding events have been recorded. Our experience demonstrates the safety profile of apixaban in cases of severe renal failure, but it also emphasizes the need for more research to confirm this evidence.","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140721311","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}
Daniele Castellucci, Miguel Angel Casado Suela, Mercedes Duffort Falco, Juan Salillas Hernando, Pilar Medrano Izquierdo, Alessandra Dimino, A. Carroccio, Juan Torres Macho
A 73-year-old woman arrived at the ER claiming to be experiencing low back pain. To investigate the source of her pain, she was admitted to the Internal Medicine department. After a heterogeneous abdominal mass in the right upper quadrant was discovered by abdominal point-of-care ultrasonography (POCUS), it was confirmed by an abdominal CT scan, which also identified a metastatic lytic bone lesion in the L4. This finding is consistent with a malignant tumor of the right adrenal gland. POCUS was repeated right after the occurrence of dyspnea, and a 40x6 mm floating thrombus in the inferior vena cava was detected. A conservative approach with anticoagulants was chosen, with improvement of the clinical conditions. The diagnosis of adrenal carcinoma was ultimately made possible by the mass biopsy. POCUS is a safe, low-cost method that provides prompt results at the patient's bedside. We support the implementation of POCUS in all clinical departments, as it provides significant contributions to the assessment of prognosis and diagnosis.
{"title":"Point-of-care ultrasonography role in detecting inferior vena cava thrombosis in a patient with low back pain: a case report","authors":"Daniele Castellucci, Miguel Angel Casado Suela, Mercedes Duffort Falco, Juan Salillas Hernando, Pilar Medrano Izquierdo, Alessandra Dimino, A. Carroccio, Juan Torres Macho","doi":"10.4081/itjm.2024.1719","DOIUrl":"https://doi.org/10.4081/itjm.2024.1719","url":null,"abstract":"A 73-year-old woman arrived at the ER claiming to be experiencing low back pain. To investigate the source of her pain, she was admitted to the Internal Medicine department. After a heterogeneous abdominal mass in the right upper quadrant was discovered by abdominal point-of-care ultrasonography (POCUS), it was confirmed by an abdominal CT scan, which also identified a metastatic lytic bone lesion in the L4. This finding is consistent with a malignant tumor of the right adrenal gland. POCUS was repeated right after the occurrence of dyspnea, and a 40x6 mm floating thrombus in the inferior vena cava was detected. A conservative approach with anticoagulants was chosen, with improvement of the clinical conditions. The diagnosis of adrenal carcinoma was ultimately made possible by the mass biopsy. POCUS is a safe, low-cost method that provides prompt results at the patient's bedside. We support the implementation of POCUS in all clinical departments, as it provides significant contributions to the assessment of prognosis and diagnosis.","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140721610","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}
A. Babker, Hanan Khalid Fadul Ahmed, R. Suliman, Ahmed Luay Osman, A. Alfeel, P. Kandakurti, S. Elzaki
This study investigated the link between angiotensin I-converting enzyme insertion/deletion (ACE I/D) polymorphism and unexplained spontaneous abortion. This retrospective analytical case-control was conducted at the Omdurman Maternity Hospital in Sudan. The current study contained 230 individuals, including 119 cases (women who had at least three abortions) of unknown cause and 119 controls (healthy women who had at least two full-term deliveries without spontaneous abortion). Patients and controls were provided five ml of ethylenediaminetetraacetic acid blood and answered questionnaires about their demographics, personal lives, and family histories. ACE I/D polymorphisms were assessed using a conventional polymerase chain reaction approach after total genomic DNA was isolated from blood leukocytes using the GF-1 blood DNA extraction kit. Data was analyzed using the Statistical Package for the Social Sciences version 24. ACE I/D polymorphism is strongly linked to unexplained spontaneous abortion, and women with the I/D and D/D genotypes are more likely to have it than those with the I/I genotype. The current study reveals that ACEI/D polymorphism increases pregnancy problems. Sudanese women may have spontaneous abortions due to the ACE I/D polymorphism.
{"title":"Strong association between angiotensin I-converting enzyme insertion/deletion polymorphism and unexplained recurrent spontaneous abortion of Sudanese women: a case-control study","authors":"A. Babker, Hanan Khalid Fadul Ahmed, R. Suliman, Ahmed Luay Osman, A. Alfeel, P. Kandakurti, S. Elzaki","doi":"10.4081/itjm.2024.1717","DOIUrl":"https://doi.org/10.4081/itjm.2024.1717","url":null,"abstract":"This study investigated the link between angiotensin I-converting enzyme insertion/deletion (ACE I/D) polymorphism and unexplained spontaneous abortion. This retrospective analytical case-control was conducted at the Omdurman Maternity Hospital in Sudan. The current study contained 230 individuals, including 119 cases (women who had at least three abortions) of unknown cause and 119 controls (healthy women who had at least two full-term deliveries without spontaneous abortion). Patients and controls were provided five ml of ethylenediaminetetraacetic acid blood and answered questionnaires about their demographics, personal lives, and family histories. ACE I/D polymorphisms were assessed using a conventional polymerase chain reaction approach after total genomic DNA was isolated from blood leukocytes using the GF-1 blood DNA extraction kit. Data was analyzed using the Statistical Package for the Social Sciences version 24. ACE I/D polymorphism is strongly linked to unexplained spontaneous abortion, and women with the I/D and D/D genotypes are more likely to have it than those with the I/I genotype. The current study reveals that ACEI/D polymorphism increases pregnancy problems. Sudanese women may have spontaneous abortions due to the ACE I/D polymorphism.","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140744559","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}
Overcrowding in emergency departments (EDs) is a common and worldwide phenomenon, widely reported even by the non-specialist press. It contributes to a number of consequences that can affect both the number of resources available and the quality of care. Strategies to address this incriminating situation for patients, nurses, doctors, and hospital administrators are urgently needed. For this reason, and based on the input from the Ministry of Health, a series of projects and procedures have been developed in various Italian regions, aimed at reducing the waiting times and the diagnostic-therapeutic process of patients arriving in the ED. In this article, we will examine the main critical issues within EDs and discuss the most impactful strategies and solutions to manage these difficulties.
{"title":"Overcrowding in emergency departments: strategies and solutions for an effective reorganization","authors":"Chiara Busti, Roberto Marchetti, Manuel Monti","doi":"10.4081/itjm.2024.1714","DOIUrl":"https://doi.org/10.4081/itjm.2024.1714","url":null,"abstract":"Overcrowding in emergency departments (EDs) is a common and worldwide phenomenon, widely reported even by the non-specialist press. It contributes to a number of consequences that can affect both the number of resources available and the quality of care. Strategies to address this incriminating situation for patients, nurses, doctors, and hospital administrators are urgently needed. For this reason, and based on the input from the Ministry of Health, a series of projects and procedures have been developed in various Italian regions, aimed at reducing the waiting times and the diagnostic-therapeutic process of patients arriving in the ED. In this article, we will examine the main critical issues within EDs and discuss the most impactful strategies and solutions to manage these difficulties.","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140221787","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}
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