Clinical global impression-severity score as a reliable measure for routine evaluation of remission in schizophrenia and schizoaffective disorders

Aims: This study aimed to compare the performance of Positive and Negative Syndrome Scale (PANSS) symptom severity criteria established by the Remission in Schizophrenia Working Group (RSWG) with criteria based on Clinical Global Impression (CGI) severity score. The 6-month duration criterion was not taken into consideration. Methods: A convenience sample of 112 chronic psychotic outpatients was examined. Symptomatic remission was evaluated according to RSWG severity criterion and to a severity criterion indicated by the overall score obtained at CGI-Schizophrenia (CGI-SCH) rating scale (≤3) (CGI-S). Results: Clinical remission rates of 50% and 49.1%, respectively, were given by RSWG and CGI-S, with a significant level of agreement between the two criteria in identifying remitted and non-remitted cases. Mean scores at CGI-SCH and PANSS scales were significantly higher among remitters, independent of the remission criteria adopted. Measures of cognitive functioning were largely independent of clinical remission evaluated according to both RSWG and CGI-S. When applying RSWG and CGI-S criteria, the rates of overall good functioning yielded by Personal and Social Performance scale (PSP) were 32.1% and 32.7%, respectively, while the mean scores at PSP scale differed significantly between remitted and non-remitted patients, independent of criteria adopted. The proportion of patients judged to be in a state of well-being on Social Well-Being Under Neuroleptics-Short Version scale (SWN-K) were, respectively, 66.1% and 74.5% among remitters according to RSWG and CGI-S; the mean scores at the SWN scale were significantly higher only among remitters according to CGI-S criteria. Conclusions: CGI severity criteria may represent a valid and user-friendly alternative for use in identifying patients in remission, particularly in routine clinical practic

Manuale del RUP : prontuario operativo del responsabile unico del procedimento

Questo Manuale operativo è rivolto al Professionista che necessita di una guida pratica e veloce per destreggiarsi senza incertezze nel variegato sistema normativo e procedurale che disciplina le attività del RUP. Si procede attraverso il censimento e la riorganizzazione di tutti i disposti normativi facenti riferimento al RUP - sia di carattere generale che specifici delle varie fasi procedurali - e successivamente ricostruendo minuziosamente l'iter dei diversi sub-procedimenti, per consentire una consultazione rapida e funzionale degli argomenti. Lo schema espositivo è volutamente semplice e lineare, si avvale di innumerevoli tabelle sinottiche e diagrammi di flusso e consente in qualsiasi punto l’immediata verifica della fonte normativa di provenienza - riportata per esteso nell’appendice normativa di ogni capitolo - per favorire un preciso riscontro delle varie prescrizioni. Ciascun capitolo è inoltre dotato di una “Scheda normo-cronologica”, che per ogni fase ricapitola gli adempimenti, elencandoli secondo l’ordine sequenziale di svolgimento. L’Opera, curata con pazienza e precisione, risulta pertanto un prezioso ed insostituibile strumento di lavoro e di semplificazione - unico nel suo genere - che coadiuva il RUP nella prioritaria esigenza di attuare le procedure in tempi brevi, verificandone al contempo la correttezza e senza rischiare di incorrere in errori o dimenticanze

Manuale del RUP : prontuario operativo del Responsabile Unico del Procedimento

Questo Manuale operativo è rivolto al Professionista che necessita di una guida pratica e veloce per destreggiarsi senza incertezze nel variegato sistema normativo e procedurale che disciplina le attività del RUP. Si procede attraverso il censimento e la riorganizzazione di tutti i disposti normativi facenti riferimento al RUP - sia di carattere generale che specifici delle varie fasi procedurali - e successivamente ricostruendo minuziosamente l’iter dei diversi subprocedimenti, per consentire una consultazione rapida e funzionale degli argomenti. Lo schema espositivo è volutamente semplice e lineare, si avvale di innumerevoli tabelle sinottiche e diagrammi di flusso e consente in qualsiasi punto l’immediata verifica della fonte normativa di provenienza - riportata per esteso nell’appendice normativa di ogni capitolo - per favorire un preciso riscontro delle varie prescrizioni. Ciascun capitolo è inoltre dotato di una “Scheda normo-cronologica”, che per ogni fase ricapitola gli adempimenti, elencandoli secondo l’ordine sequenziale di svolgimento. L’accurato indice analitico introdotto in questa terza edizione facilita inoltre il reperimento dei tanti argomenti oggetto di trattazione. L’Opera, curata con pazienza e precisione, risulta pertanto un prezioso ed insostituibile strumento di lavoro e di semplificazione - unico nel suo genere - che coadiuva il RUP nella prioritaria esigenza di attuare le procedure in tempi brevi, verificandone al contempo la correttezza e senza rischiare di incorrere in errori o dimenticanze

Medium- and long-term re-treatment of root canals filled with a calcium silicate-based sealer: an experimental ex vivo study

This study investigated the possibility of re-treating a calcium silicate-based sealer (CSBS), compared to an epoxy-resin sealer (RBS), using rotary instrumentation at different times from obturation (1 month/1 year). Thirty-six human mandibular premolars, extracted as a result of orthodontic or periodontal problems, were instrumented and randomly divided into three groups of 12: BR and BR*, which were filled with CSBS and re-treated after one month and one year of storage, respectively, and AH, which was filled with RBS and re-treated after one month. The same re-treatment protocol was used for all teeth, and the times required for the procedure was recorded. The re-treated specimens were longitudinally sectioned and examined at the stereomicroscope (SM) at 20× magnification. Image J Software was used to process the microphotographs. The percentage of residual filling materials in the root canal and the apical third, the ability to reach working length WL and patency, and the time taken to complete the re-treatment were recorded and analyzed by ANOVA and post hoc Bonferroni test (p = 0.05). Scanning electron microscopy (SEM) and coupled energy-dispersive spectroscopy (EDS) were applied to representative samples to evaluate canal cleanliness and chemical elements. Patency and WL were re-established in all of the teeth. Residual filling materials were retained in all specimens of the three groups. The mean percentage of residual materials was significantly different between BR and BR* (p-value = 0.048), with BR* showing the highest values. The mean time to complete re-treatment was significantly lower for AH, followed by BR (p = 0.0001) and BR* (p = 0.0078). Conclusions: After both medium and long storage periods, the CSBS can be concluded to have been successfully removed from canals with simple anatomy

Consensus statements on vaccination in patients with haemophilia-Results from the Italian haemophilia and vaccinations (HEVA) project

Vaccination against communicable diseases is crucial for disease prevention, but this practice poses challenges to healthcare professionals in patients with haemophilia. Poor knowledge of the vaccination requirements for these patients and safety concerns often result in vaccination delay or avoidance. In order to address this issue, a panel of 11 Italian haemophilia and immunization experts conducted a Delphi consensus process to identify the main concerns regarding the safe use of vaccines in patients with haemophilia. The consensus was based on a literature search of the available evidence, which was used by the experts to design 27 consensus statements. A group of clinicians then rated these statements using the 5-point Likert-type scale (1 = strongly disagree; 5 = strongly agree). The main issues identified by the expert panel included vaccination schedule for haemophilic patients; protocol and optimal route of vaccine administration; vaccination of haemophilic patients with antibodies inhibiting coagulation factor VIII (inhibitors); and vaccination and risk of inhibitor development. This manuscript discusses these controversial areas in detail supported by the available literature evidence and provides evidence- and consensus-based recommendations. Overall, participants agreed on most statements, except those addressing the potential role of vaccination in inhibitor formation. Participants agreed that patients with haemophilia should receive vaccinations according to the institutional schedule for individuals without bleeding disorders; however, vaccination of patients with haemophilia requires comprehensive planning, taking into account disease severity, type and route of vaccination, and bleeding risk. Data also suggest vaccination timing does not need to take into consideration when the patient received factor VIII replacement