La pratica filosofica nell'epoca della post-verità.

Il contributo riflette sulla sfida lanciata dalla post-verità alla pratica filosofica. Il fenomeno della post-verità, a partire dal significato del prefissso post-, comporta un processo di problematizzazione della verità , il quale attiva la dimensione critica della filosofia così come delineata ad esempio da Michel Foucault. Lo scenario aperto dalla post-verità, in questo senso, non si presenta come quello in cui della verità non ne è più niente, bensì quello in cui ci si può fare carico della verità in tutta la sua complessità e articolazioni

The reorganization of healthcare services from the perspective of appropriateness: The experience of the University Hospital "San Giovanni di Dio e Ruggi d'Aragona" in the management of Diagnosis-Related Group no. 127 - Heart failure and shock|La riorganizzazione delle prestazioni sanitarie in ottica di appropriatezza: L'esperienza dell'AOU “San Giovanni di Dio e Ruggi d'Aragona” nella gestione del DRG 127 - Insufficienza cardiaca e shock

The article proposes a care path intended to improve the standards of specialist care in the field of heart failure, in compliance with the criteria of effectiveness, efficiency and equity on which the Italian National Health Service (INHS) relies. A case study approach was undertaken. The attention was focused on the experience of the University Hospital “San Giovanni di Dio e Ruggi d'Aragona” located in Salerno, Southern Italy. In particular, data were collected from with the collaboration of the “Hospital Discharge Form” office. Examining a set of indicators - such as the average hospitalization and percentage of hospitalizations - about the Diagnosis-Related Group no. 127 “Heart failure and intensive cardiology shock” in the financial year 2017, we untangled the criticalities of the existing process and, adopting the Business Process Improvement (BPI) methodology, we proposed a process redesign. Technology, asset management, care paths, training, and monitoring were identified as the primary levers to enhance the standards of specialist care in the field of heart failure

Risk factors for pelvic endometriosis in women with pelvic pain or infertility

Objective: The objective of the study was to analyse the relationship between selected characteristics and risk of pelvic endometriosis. Study design: Eligible for the study were 817 women with primary or secondary infertility or pelvic pain requiring laparoscopy. Of these, 393 were included for infertility and 424 for pelvic pain. Results: A total of 345 (42.2%) had a diagnosis of endometriosis and 472 did not have the disease. Multiparous women had endomertriosos less frequently than nulliparous, the estimated odds ratios (OR) were respectively 0.9 (95% confidence interval, CI, 0.5-1.6) and 0.4 (95% CI 0.2-0.7) in women reporting one and two or more births. In comparison with women reporting no spontaneous abortion, the estimated OR was 0.3 (95% CI 0.2-0.5) in those who reported greater than or equal to 1 miscarriage. In comparison with women reporting menstrual cycles lasting greater than or equal to 25 days subjects with totally irregular menstrual cycles had a reduced risk of endometriosis (OR 0.6, 95% CI 0.3-0.9). No significant association emerged between smoking, age at menarche and risk of endometriosis. Conclusions: this study confirms, with a different methodological approach to previously published studies, that multiparity, a history of abortion and lifelong irregular menstrual pattern decrease the risk of endometriosis in women with pelvic pain and infertility. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved

Estroprogestin vs. gonadotrophin agonists plus estroprogestin in the treatment of endometriosis-related pelvic pain: a randomized trial. Gruppo Italiano per lo Studio dell'Endometriosi

OBJECTIVE: This is a randomized clinical trial comparing estroprogestin (E/P) pill given for 12 months vs. gonadotrophin releasing hormone agonist (GNRHa) given for 4 months followed by E/P pill treatment for 8 months in the relief of endometriosis-related pelvic pain. METHODS: Eligible for the study were women with laparoscopically confirmed endometriosis and pelvic pain lasting 3-12 months after diagnosis. Eligible women were randomly assigned to treatment with E/P pill (gestroden 0.75 mg and ethynlestradiol 0.03 mg) for 12 months (47 patients) vs. tryptorelin 3.75 mg slow release every 28 days for 4 months followed by E/P pill for 8 months (55 patients). RESULTS: At baseline, dysmenorrhea was reported in 46 women allocated to E/P pill only (97.9%), and in all the 55 women allocated to GNRHa+E/P pill. The corresponding value at the 12 months follow-up visit was 14 subjects (35.9%) and 16 subjects (34.8%). The baseline median values of the multidimensional and analog scale were for dysmenorrhea 4 and 6 in the EP only and 3 and 6 in the GNRHa+E/P group. The corresponding value at the 12 months follow-up visit were 2 and 6 and 0 and 5. Non-menstrual pain was reported, respectively, at baseline and 12 month visit by 46 (97.9%) and 15 (38.5%) subjects in the E/P pill group and 49 (89.1%) and 17 (37.0%) of the GNRHa+E/P pill one. The baseline median values of the multidimensional and analog scale were for non-menstrual pain 3 and 5 in the E/P only and 2 and 6 in the GNRHa+E/P group. The corresponding values at the 12 month follow-up visit were 0 and 4 and 0 and 4. These differences between the two groups were not statistically significant

Estroprogestin vs. gonadotrophin agonists plus estroprogestin in the treatment of endometriosis-related pelvic pain: a rnadomized trial. Gruppo Italiano per lo studio dell'endometriosi

Estroprogestin vs. gonadotrophin agonists plus estroprogestin in the treatment of endometriosis-related pelvic pain: a randomized trial. Gruppo Italiano per lo Studio dell'Endometriosi

Oral contraceptive use and risk of endometriosis. Italian Endometriosis Study Group.

Objective. To analyse the association between use of oral contraception and risk of pelvic endometriosis. Design. We compared use of oral contraception in women with and without endometriosis. Participants. Eligible for the study were women with primary or secondary infertility (n = 393) or chronic pelvic pain (n = 424), requiring laparoscopy, consecutively observed between September 1995 and January 1996 in 15 obstetrics and gynaecology departments in Italy. Results. Out of the 817 women included in the study, 345 had a diagnosis of endometriosis; 164 (47.5%) women with endometriosis and 139 (29.4%) without the disease reported ever using oral contraception. In comparison with never users the estimated odds ratios (OR) of endometriosis were 1.8 (95% CI 1.0-3.3) in current users and 1.6 (95% CI 1.1-2.4) in ex-users. No clear relation emerged between duration of oral contraceptive use and risk of endometriosis. In comparison with never users, the OR was 1.8 (95% CI 1.1-3.0) for women reporting their last use of oral contraception < 5 years before interview and 1.5 (95% CI 0.9-2.5) for those reporting their last use 65 5 years before interview. Conclusions. The study suggests that oral contraception is associated with an increased risk of endometriosis but this finding is based on a selected population and cannot generalised to all women with endometriosis

Risk factors for pelvic endometriosis in women with pelvic pain or infertility. Gruppo Italiano per lo Studio dell' endometriosi

31OBJECTIVE: The objective of the study was to analyse the relationship between selected characteristics and risk of pelvic endometriosis. STUDY DESIGN: Eligible for the study were 817 women with primary or secondary infertility or pelvic pain requiring laparoscopy. Of these, 393 were included for infertility and 424 for pelvic pain. RESULTS: A total of 345 (42.2%) had a diagnosis of endometriosis and 472 did not have the disease. Multiparous women had endometriosis less frequently than nulliparous, the estimated odds ratios (OR) were respectively 0.9 (95% confidence interval, CI, 0.5-1.6) and 0.4 (95% CI 0.2-0.7) in women reporting one and two or more births. In comparison with women reporting no spontaneous abortion, the estimated OR was 0.3 (95% CI 0.2-0.5) in those who reported > or =1 miscarriage. In comparison with women reporting menstrual cycles lasting > or =25 days subjects with totally irregular menstrual cycles had a reduced risk of endometriosis (OR 0.6, 95% CI 0.3-0.9). No significant association emerged between smoking, age at menarche and risk of endometriosis. CONCLUSIONS: this study confirms, with a different methodological approach to previously published studies, that multiparity, a history of abortion and lifelong irregular menstrual pattern decrease the risk of endometriosis in women with pelvic pain and infertility.nonenoneF. Parazzini; I. Ardovino; E. Struzziero; E. Zanardi; D. Pungetti; V. Mais; S. Aiossa; G. Mignemi; L. Di Leo; A. Bianchi; C. Campobasso; G. Scarselli; G. Bracco; P. Capetta; C. Bertulessi; S. Moroni; P. Mazza; P. Vercellini; P.G. Crosignani; A. Bacchi Modena; A. Casa; M. Massobrio; C. Ansaldi; G. Trossarelli; M.T. Gervasi; V. Marsoni; S. Guaschino; L. Troiano; G. Ricci; P. Beretta; M. FranchiF., Parazzini; I., Ardovino; E., Struzziero; E., Zanardi; D., Pungetti; V., Mais; S., Aiossa; G., Mignemi; L., Di Leo; A., Bianchi; C., Campobasso; G., Scarselli; G., Bracco; P., Capetta; C., Bertulessi; S., Moroni; P., Mazza; P., Vercellini; P. G., Crosignani; A., Bacchi Modena; A., Casa; M., Massobrio; C., Ansaldi; G., Trossarelli; M. T., Gervasi; V., Marsoni; Guaschino, Secondo; L., Troiano; Ricci, Giuseppe; P., Beretta; M., Franch