Adverse Events Capture Systems, Checklists and Teamwork as Relevant Tools to Reduce Complications and Increase Patients’ Safety in Spinal Surgery

Adverse events in Hospitals are often related to surgery and they represent a relevant problem in healthcare. Different approaches have been introduced during the last decade to address the problem of patient safety, especially in the surgical environment. The teamwork is crucial in all these actions which aim to decrease adverse events and improve clinical outcomes. We analyze in particular the use of adverse events capture systems in spinal surgery and the use of checklist systems, starting from the Surgical Safety Checklist introduced by the World Health Organization (WHO) in 2008

Development and characterization of a novel human 3D model of bone metastasis from breast carcinoma in vitro cultured

Breast cancer frequently metastasizes to the skeleton causing significant morbidity. Here, we set-up a novel and advanced ex vivo model by using fresh tissue from human vertebral bone metastasis from breast carcinoma patients able to retain the tumor microenvironment and tumor cells heterogeneity

Potent In Vitro Activity of Citrus aurantium Essential Oil and Vitis vinifera Hydrolate Against Gut Yeast Isolates from Irritable Bowel Syndrome Patients\u2014The Right Mix for Potential Therapeutic Use

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Стан та перспективи конкурентоспроможності галузі національного господарства в умовах глобалізації

Метою дослідження є узагальнення нових теоретичних положень розвитку галузей економіки в умовах глобалізації, визначення загальних конкурентних переваг хімічної галузі України та практичних напрямів сучасного розвитку економіки країни

Dal collezionismo privato alle istituzioni pubbliche

Il progetto, nato all\u2019interno di corso di Museologia e collezionismo della Scuola di Specializzazione in Beni storico-artistici \u2013 DAR, riguarda la schedatura di opere conservate in istituzioni molto diverse l'una dall'altra e costituiscono una testimonianza della variet\ue0 di approcci e di fonti relative alla storia del collezionismo. Con introduzione di M. Pigozzi e schede di A. Barbanti, G. Cali, I. Carozza, I. Chia, L. Coppa, A. Di Maio, Cristina Elia, C. Forconi, F. Gamba, A. Lisbona, M. Mariano, S. Mauro, F. Passerini, L. Regano, G.M. Sassoli de\u2019 Bianchi Strozzi, I. Siboni, S. Zugni

The mediterranean sea we want

open58siThis paper presents major gaps and challenges for implementing the UN Decade of Ocean Science for Sustainable Development (2021-2030) in the Mediterranean region. The authors make recommendations on the scientific knowledge needs and co-design actions identified during two consultations, part of the Decade preparatory-phase, framing them in the Mediterranean Sea’s unique environmental and socio-economic perspectives. According to the ‘Mediterranean State of the Environment and Development Report 2020’ by the United Nations Environment Programme Mediterranean Action Plan and despite notable progress, the Mediterranean region is not on track to achieve and fully implement the Sustainable Development Goals of Agenda 2030. Key factors are the cumulative effect of multiple human-induced pressures that threaten the ecosystem resources and services in the global change scenario. The basin, identified as a climate change vulnerability hotspot, is exposed to pollution and rising impacts of climate change. This affects mainly the coastal zones, at increasing risk of extreme events and their negative effects of unsustainable management of key economic assets. Transitioning to a sustainable blue economy is the key for the marine environment’s health and the nourishment of future generations. This challenging context, offering the opportunity of enhancing the knowledge to define science-based measures as well as narrowing the gaps between the Northen and Southern shores, calls for a joint (re)action. The paper reviews the state of the art of Mediterranean Sea science knowledge, sets of trends, capacity development needs, specific challenges, and recommendations for each Decade’s societal outcome. In the conclusions, the proposal for a Mediterranean regional programme in the framework of the Ocean Decade is addressed. The core objective relies on integrating and improving the existing ocean-knowledge, Ocean Literacy, and ocean observing capacities building on international cooperation to reach the “Mediterranean Sea that we want”.openCappelletto M.; Santoleri R.; Evangelista L.; Galgani F.; Garces E.; Giorgetti A.; Fava F.; Herut B.; Hilmi K.; Kholeif S.; Lorito S.; Sammari C.; Lianos M.C.; Celussi M.; D'alelio D.; Francocci F.; Giorgi G.; Canu D.M.; Organelli E.; Pomaro A.; Sannino G.; Segou M.; Simoncelli S.; Babeyko A.; Barbanti A.; Chang-Seng D.; Cardin V.; Casotti R.; Drago A.; Asmi S.E.; Eparkhina D.; Fichaut M.; Hema T.; Procaccini G.; Santoro F.; Scoullos M.; Solidoro C.; Trincardi F.; Tunesi L.; Umgiesser G.; Zingone A.; Ballerini T.; Chaffai A.; Coppini G.; Gruber S.; Knezevic J.; Leone G.; Penca J.; Pinardi N.; Petihakis G.; Rio M.-H.; Said M.; Siokouros Z.; Srour A.; Snoussi M.; Tintore J.; Vassilopoulou V.; Zavatarelli M.Cappelletto M.; Santoleri R.; Evangelista L.; Galgani F.; Garces E.; Giorgetti A.; Fava F.; Herut B.; Hilmi K.; Kholeif S.; Lorito S.; Sammari C.; Lianos M.C.; Celussi M.; D'alelio D.; Francocci F.; Giorgi G.; Canu D.M.; Organelli E.; Pomaro A.; Sannino G.; Segou M.; Simoncelli S.; Babeyko A.; Barbanti A.; Chang-Seng D.; Cardin V.; Casotti R.; Drago A.; Asmi S.E.; Eparkhina D.; Fichaut M.; Hema T.; Procaccini G.; Santoro F.; Scoullos M.; Solidoro C.; Trincardi F.; Tunesi L.; Umgiesser G.; Zingone A.; Ballerini T.; Chaffai A.; Coppini G.; Gruber S.; Knezevic J.; Leone G.; Penca J.; Pinardi N.; Petihakis G.; Rio M.-H.; Said M.; Siokouros Z.; Srour A.; Snoussi M.; Tintore J.; Vassilopoulou V.; Zavatarelli M

Off-label long acting injectable antipsychotics in real-world clinical practice: a cross-sectional analysis of prescriptive patterns from the STAR Network DEPOT study

Introduction Information on the off-label use of Long-Acting Injectable (LAI) antipsychotics in the real world is lacking. In this study, we aimed to identify the sociodemographic and clinical features of patients treated with on- vs off-label LAIs and predictors of off-label First- or Second-Generation Antipsychotic (FGA vs. SGA) LAI choice in everyday clinical practice. Method In a naturalistic national cohort of 449 patients who initiated LAI treatment in the STAR Network Depot Study, two groups were identified based on off- or on-label prescriptions. A multivariate logistic regression analysis was used to test several clinically relevant variables and identify those associated with the choice of FGA vs SGA prescription in the off-label group. Results SGA LAIs were more commonly prescribed in everyday practice, without significant differences in their on- and off-label use. Approximately 1 in 4 patients received an off-label prescription. In the off-label group, the most frequent diagnoses were bipolar disorder (67.5%) or any personality disorder (23.7%). FGA vs SGA LAI choice was significantly associated with BPRS thought disorder (OR = 1.22, CI95% 1.04 to 1.43, p = 0.015) and hostility/suspiciousness (OR = 0.83, CI95% 0.71 to 0.97, p = 0.017) dimensions. The likelihood of receiving an SGA LAI grew steadily with the increase of the BPRS thought disturbance score. Conversely, a preference towards prescribing an FGA was observed with higher scores at the BPRS hostility/suspiciousness subscale. Conclusion Our study is the first to identify predictors of FGA vs SGA choice in patients treated with off-label LAI antipsychotics. Demographic characteristics, i.e. age, sex, and substance/alcohol use co-morbidities did not appear to influence the choice towards FGAs or SGAs. Despite a lack of evidence, clinicians tend to favour FGA over SGA LAIs in bipolar or personality disorder patients with relevant hostility. Further research is needed to evaluate treatment adherence and clinical effectiveness of these prescriptive patterns

The Role of Attitudes Toward Medication and Treatment Adherence in the Clinical Response to LAIs: Findings From the STAR Network Depot Study

Background: Long-acting injectable (LAI) antipsychotics are efficacious in managing psychotic symptoms in people affected by severe mental disorders, such as schizophrenia and bipolar disorder. The present study aimed to investigate whether attitude toward treatment and treatment adherence represent predictors of symptoms changes over time. Methods: The STAR Network \u201cDepot Study\u201d was a naturalistic, multicenter, observational, prospective study that enrolled people initiating a LAI without restrictions on diagnosis, clinical severity or setting. Participants from 32 Italian centers were assessed at three time points: baseline, 6-month, and 12-month follow-up. Psychopathological symptoms, attitude toward medication and treatment adherence were measured using the Brief Psychiatric Rating Scale (BPRS), the Drug Attitude Inventory (DAI-10) and the Kemp's 7-point scale, respectively. Linear mixed-effects models were used to evaluate whether attitude toward medication and treatment adherence independently predicted symptoms changes over time. Analyses were conducted on the overall sample and then stratified according to the baseline severity (BPRS < 41 or BPRS 65 41). Results: We included 461 participants of which 276 were males. The majority of participants had received a primary diagnosis of a schizophrenia spectrum disorder (71.80%) and initiated a treatment with a second-generation LAI (69.63%). BPRS, DAI-10, and Kemp's scale scores improved over time. Six linear regressions\u2014conducted considering the outcome and predictors at baseline, 6-month, and 12-month follow-up independently\u2014showed that both DAI-10 and Kemp's scale negatively associated with BPRS scores at the three considered time points. Linear mixed-effects models conducted on the overall sample did not show any significant association between attitude toward medication or treatment adherence and changes in psychiatric symptoms over time. However, after stratification according to baseline severity, we found that both DAI-10 and Kemp's scale negatively predicted changes in BPRS scores at 12-month follow-up regardless of baseline severity. The association at 6-month follow-up was confirmed only in the group with moderate or severe symptoms at baseline. Conclusion: Our findings corroborate the importance of improving the quality of relationship between clinicians and patients. Shared decision making and thorough discussions about benefits and side effects may improve the outcome in patients with severe mental disorders

Heat-Induced Gelation of Chickpea and Faba Bean Flour Ingredients

This study aimed to investigate the gelling behavior of faba bean (FB) and chickpea (CP) flour between 10 and 20% (w/w) concentration at pH 3.0, 5.0, and 7.0. Both sources formed at pH 3.0 and 5.0 self-standing gels with 12% (w/w) of flour, while 16% (w/w) of flour was required to obtain a gel at pH 7.0. During gelling between 40 and 70 °C, a sharp increase of the elastic modulus G′ was observed in both flours, mainly due to water absorption and swelling of the starch, one of the major constituents in the ingredients. Increasing the temperature at 95 °C, G′ increased due to the denaturation of globulins and therefore the exposure of their internal part, which allowed more hydrophobic interactions and the formation of the gel. After cooling, both FB and CP gels displayed a solid-like behavior (tan δ ranging between 0.11 and 0.18) with G′ values at pH 3.0 and 5.0 significantly (p < 0.05) higher than those at pH 7.0, due to the lower electrostatic repulsions at pHs far from the isoelectric point. The rheological properties were supported by the water binding capacity values, confirming the better gels’ strength described by rheological analysis. These results will enhance our understanding of the role of legume flours in formulating innovative and sustainable food products as alternatives to animal ones

Osteonecrosis of the Jaw in Patients with Bone Metastases Treated with Bisphosphonates: A Retrospective Study

Abstract Learning Objectives After completing this course, the reader will be able to: Discuss the importance of treating patients with bone metastases using a multidisciplinary approach.Explain why bisphosphonates are a fundamental part of bone metastasis treatment.Evaluate the main features of ONJ and, in particular, its high risk factor.Describe the importance of ONJ prevention during bisphosphonate treatment.Emphasize the importance of interaction among the patient's dentist, surgeon, and oncologist for the management of ONJ. CME Access and take the CME test online and receive 1 AMA PRA Category 1 Credit™ at CME.TheOncologist.com Objective. Bone metastases are a major cause of morbidity in cancer patients. Treatment includes bisphosphonates, which are also associated with avascular osteonecrosis of the jaw (ONJ). Our aim was to evaluate the correlation between bisphosphonates and ONJ. Patients and Methods. Of the 539 patients with bone metastases treated in our department from June 2002 to December 2006 with i.v. bisphosphonates, eight (1.5%) developed ONJ. Results. The eight patients with ONJ had all been given zoledronic acid, and two had also been treated with pamidronic acid. In four of the patients, ONJ was diagnosed during treatment, while in the remaining four it was diagnosed several months after therapy with bisphosphonates had ended. Six of these patients received local noninvasive treatment, of whom five progressed. Two showed apparent autolimitation of the disease. The remaining two patients underwent surgical resection and currently show no signs of relapse. All eight ONJ patients presented with various concomitant risk factors such as paradontopathy, dental extraction, or spontaneous avulsion. Conclusions. Our results show that ONJ can appear months after interruption of treatment and that a surgical approach can be used in suitable cases. Closer cooperation is needed among specialists to define guidelines for the prevention of ONJ in patients with bone metastases