Mental disorder and the use of public psychiatric services in the foreigner population of the Canton Ticino

Scopo - Verificare se la popolazione straniera residente nel Canton Ticino differisce nell'utilizzazione delle strutture psichiatriche pubbliche e nel tipo di disagio psichico presentato, rispetto alia popolazione svizzera. Disegno Indagine compiuta sui soggetti di nazionalità svizzera e straniera, con più di 19 anni d'età, residenti nel Cantone Ticino, che hanno avuto nel corso del 1995 almeno un giorno di ricovero presso l'ospedale psichiatrico o almeno un contatto con gli ambulatori. Setting I servizi pubblici dell'Organizzazione sociopsichiatrica cantonale del Canton Ticino. Principali misure utilizzate - Sono stati calcolati per gli svizzeri, gli italiani e gli stranieri non italiani i tassi annuali standardizzati di prevalenza ospedaliera e ambulatoriale e i tassi di prima ammissione e primo contatto ambulatoriale, totali e per categorie diagnostiche (ICD-10). Risultati - Il gruppo degli stranieri non italiani presenta tassi annuali standardizzati totali di prevalenza ospedaliera e, soprattutto, di prima ammissione più elevati rispetto agli svizzeri e agli italiani; inoltre presenta, rispetto agli altri due gruppi, tassi di prima ammissione più alti per le sindromi schizofreniche (F2), negli uomini e per i disturbi psichici dovuti all'uso di sostanze psicoattive (Fl), nelle donne. Mentre nei primi contatti ambulatoriali gli altri stranieri presentano tassi più alti di sindromi nevrotiche, legate a stress e somatoformi (F4), negli uomini e di sindromi affettive (F3), nelle donne. Conclusioni - I risultati ottenuti sembrano confermare la presenza di livelli più alti di disagio psichico tra gli stranieri non italiani, soprattutto per alcune nazionalità, rispetto agli svizzeri e agli italiani. E possibile che la presenza di una consistente offerta di servizi psichiatrici da parte del settore privato possa aver sottostimato l'effettivo disagio psichico, soprattutto nel gruppo degli svizzeri e, in modo minore, in quello degli italian

How future surgery will benefit from SARS-COV-2-related measures: a SPIGC survey conveying the perspective of Italian surgeons

COVID-19 negatively affected surgical activity, but the potential benefits resulting from adopted measures remain unclear. The aim of this study was to evaluate the change in surgical activity and potential benefit from COVID-19 measures in perspective of Italian surgeons on behalf of SPIGC. A nationwide online survey on surgical practice before, during, and after COVID-19 pandemic was conducted in March-April 2022 (NCT:05323851). Effects of COVID-19 hospital-related measures on surgical patients' management and personal professional development across surgical specialties were explored. Data on demographics, pre-operative/peri-operative/post-operative management, and professional development were collected. Outcomes were matched with the corresponding volume. Four hundred and seventy-three respondents were included in final analysis across 14 surgical specialties. Since SARS-CoV-2 pandemic, application of telematic consultations (4.1% vs. 21.6%; p < 0.0001) and diagnostic evaluations (16.4% vs. 42.2%; p < 0.0001) increased. Elective surgical activities significantly reduced and surgeons opted more frequently for conservative management with a possible indication for elective (26.3% vs. 35.7%; p < 0.0001) or urgent (20.4% vs. 38.5%; p < 0.0001) surgery. All new COVID-related measures are perceived to be maintained in the future. Surgeons' personal education online increased from 12.6% (pre-COVID) to 86.6% (post-COVID; p < 0.0001). Online educational activities are considered a beneficial effect from COVID pandemic (56.4%). COVID-19 had a great impact on surgical specialties, with significant reduction of operation volume. However, some forced changes turned out to be benefits. Isolation measures pushed the use of telemedicine and telemetric devices for outpatient practice and favored communication for educational purposes and surgeon-patient/family communication. From the Italian surgeons' perspective, COVID-related measures will continue to influence future surgical clinical practice

Textbook outcome in urgent early cholecystectomy for acute calculous cholecystitis: results post hoc of the S.P.Ri.M.A.C.C study

Introduction: A textbook outcome patient is one in which the operative course passes uneventful, without complications, readmission or mortality. There is a lack of publications in terms of TO on acute cholecystitis. Objetive: The objective of this study is to analyze the achievement of TO in patients with urgent early cholecystectomy (UEC) for Acute Cholecystitis. and to identify which factors are related to achieving TO. Materials and methods: This is a post hoc study of the SPRiMACC study. It ́s a prospective multicenter observational study run by WSES. The criteria to define TO in urgent early cholecystectomy (TOUEC) were no 30-day mortality, no 30-day postoperative complications, no readmission within 30 days, and hospital stay ≤ 7 days (75th percentile), and full laparoscopic surgery. Patients who met all these conditions were taken as presenting a TOUEC. Outcomes: 1246 urgent early cholecystectomies for ACC were included. In all, 789 patients (63.3%) achieved all TOUEC parameters, while 457 (36.6%) failed to achieve one or more parameters and were considered non-TOUEC. The patients who achieved TOUEC were younger had significantly lower scores on all the risk scales analyzed. In the serological tests, TOUEC patients had lower values for in a lot of variables than non-TOUEC patients. The TOUEC group had lower rates of complicated cholecystitis. Considering operative time, a shorter duration was also associated with a higher probability of reaching TOUEC. Conclusion: Knowledge of the factors that influence the TOUEC can allow us to improve our results in terms of textbook outcome

Cognitive stimulation in cognitively impaired individuals and cognitively healthy individuals with a family history of dementia: short-term results from the “Allena-Mente” randomized controlled trial.

Objective We evaluated the short-term efficacy of a protocol of cognitive stimulation (CS), compared with a sham intervention, on cognitive performance in cognitively healthy individuals with a family history of dementia (NDFAM) and in non-demented individuals with cognitive impairment (CI). Methods We performed a randomized controlled trial of CS in NDFAM and CI. CS consisted in 10 twice weekly meetings of CS focused on a specific cognitive area. CS was compared with a sham intervention (CT) using Mini-mental state examination (MMSE), Montreal Cognitive Assessment (MoCA), and the Corsi test. All study participants were typed for the presence of apolipoprotein E (APOE)-Ɛ4. Results Cognitively healthy NDFAM showed a higher net cognitive gain after CS, as reflected in their MoCA score, and a borderline significant net increase in visuospatial memory (Corsi test) compared with those receiving the CT. APOE-Ɛ4 carriers showed a less significant improvement on the Corsi test with respect to APOE-Ɛ4 non-carriers. In the CI sample, the MoCA and Corsi test results did not differ between the cognitively stimulated subjects and the controls. No changes in MMSE scores were found in either sample of subjects. Conclusions These findings suggest that CS as structured in this study is an effective treatment in cognitively healthy individuals, whereas it is less effective in individuals with CI. Moreover, evaluation of APOE-Ɛ4 status provided evidence of a substantial genetic contribution to the efficacy of CS on visuospatial memory as measured using the Corsi test

Reasons for dissatisfaction: a survey of relatives of intensive care patients who died

{OBJECTIVE}: To describe the reasons for eventual dissatisfaction among the families of patients who died in the intensive care unit (ICU), regarding both the assistance offered during the patient's stay in the hospital and the information received from the medical staff. {DESIGN}: Cross-sectional descriptive study, which was conducted after a survey using a questionnaire. {SETTING}: Interdisciplinary ICU (n = 8 beds) at San Giovanni Hospital in Bellinzona (CH). {SUBJECTS}: Three-hundred ninety families of patients who died in the ICU. {INTERVENTIONS}: None. {MEASUREMENTS AND MAIN RESULTS}: A postal questionnaire (n = 43 questions) was sent to the families of 390 patients who died in the ICU during 8 yrs (1981 to 1989). The results referred to 123 replies: a) 82.6% of the respondents expressed no criticism of the patient's hospital stay; b) 90% considered the patient's treatment was adequate; c) 17% felt that the information received concerning diagnosis was insufficient or unclear; and d) 30% (particularly close relatives and those relatives who were informed of the death by telephone and not in person) expressed dissatisfaction regarding the information received on the cause of death. {CONCLUSIONS}: Our survey found that the relatives of patients who died were most dissatisfied with the care received according to: a) the type of death (e.g., sudden death vs. death preceded by a gradual deterioration in the patient's condition); and b) the manner in which the relatives were notified of the death (in person vs. by telephone). The personal characteristics of the people interviewed, such as gender and the closeness of their relationship to the deceased, also seem to have some bearing on the opinions expressed. A high percentage of respondents were satisfied with the treatment received by their dying relative and the information conveyed by caregivers. Nevertheless, the dissatisfaction expressed by some respondents indicates a need for improvement, especially in communicating information to the relatives of these patients