Holder System for External Pumps Positioned Remote from the CPB Console: 23 Years’ Experience

Since 1995, our objective is to set up the extracorporeal circulation (ECC) in a manner that is both safe and versatile with a holder system which makes possible to install the oxygenator and vacuum-assisted venous drainage (VAVD) hard-shell venous reservoir (HSVR) together with the external pumps, at a distance from the cardiopulmonary bypass (CPB) console but at the same height as the patient’s shoulder. The aim is to reduce the effects of ECC by reducing surface of air/blood, blood/materials contact, the dead space of the system and priming volume of the circuit. Our ECC systems have a biocompatible surface treatment, the oxygenator and HSVR are adapted to the patient (body surface area, pathologies, etc.) and circuit includes short 3/8 in arterial and venous line (adult patients). We introduced into routine VAVD, retrograde autologous priming (RAP), including arterial line, arterial filter and antegrade autologous priming of the venous line (VAP) before the start of ECC. To confirm this development strategy of the ECC, we conducted a series of studies that have permitted to demonstrate the positive impact on postoperative outcomes of patients. Since September 2007, our objective was attained through the creation of a holder system (System U. Borrelli)

Vindex Neapolitanae nobilitatis Caroli Borrelli cleric. regul. minor. animaduersio in Francisci Aelii Marchesii librum de Neapoletanis familiis

Fregio xil. sul front.Iniziali e fregi xil.Testo in caratteri romani e corsivi.[20], 208, 186, [18] p. ; 4°Segn.: π4 [*]6 A-2C4, 2A-2A4 2B6. -Ultima c. bianca.Contiene, a c. 2A1r: Litterarum ab antiquitate repetitarum monumenta quae Francisci Aelij Marchesij errata detegunt: ...Legatura in pergamena rigida; tagli colorati di verdi; 20 x 14,5 cmSul dorso nota ms“Borrell: Animad:Neap

The Use of Carbohydrate-Deficient Transferrin in Occupational Setting: A Systematic Review

Background: Alcohol consumption is prohibited in some categories of workers due to its temporary and longterm effects. The purpose of this study is to review and evaluate the use of carbohydrate-deficient transferrin (CDT) as a biomarker to screen alcohol consumption in workers. Methods: A systematic review was performed, searching three databases, PubMed, Scopus and Isi Web of Knowledge, up to December 2021, screening for studies that used CDT as a biomarker in workers. A quality assessment was performed on the included studies. Results: Seven studies met the inclusion criteria, accounting for more than 3200 workers from five different countries; in the samples observed, a positive percentage of CDT was found in the single studies between 7 and 24%. The large interval could be due to the differences in populations in the included studies; furthermore, not all workers are prohibited from drinking on the job. Four out of the seven studies also included questionnaires on alcohol consumption assessment. Finally, included articles were stratified by occupational hazards and by industrial sector. Interestingly, different methods of analysis and different cut-offs were used by the different authors. Conclusions: The use of CDT as a biomarker of alcohol consumption has high specificity. However, further studies are needed to be able to strongly validate the use of CDT for screening purposes in the working population to detect alcohol abuse

Impact of COVID-19 on Uro-Oncological Patients: A Comprehensive Review of the Literature

Background: The aim of this paper is to discuss the impact of COVID-19 on patients with urological malignancies (prostate cancer, bladder and upper tract urothelial cancer, kidney cancer, penile and testicular cancer) and to review the available recommendations reported in the literature. Methods: A review was performed, through the PubMed database, regarding available recommendations reported in the literature, to identify studies examining the impact of COVID-19 on treatment and clinical outcomes (including upstaging, recurrence, and mortality) for uro-oncological patients. Results: The COVID-19 pandemic dramatically changed the urological guidelines and patients’ access to screening programs and follow-up visits. Great efforts were undertaken to guarantee treatments to high-risk patients although follow up was not always possible due to recurrent surges, and patients with lower risk cancers had to wait for therapies. Conclusions: Physically and mentally, uro-oncological patients paid a heavy price during the COVID-19 pandemic. Long term data on the “costs” of clinical decisions made during the COVID-19 pandemic are still to be revealed and analyzed

Returning to work and the impact of post COVID-19 condition: A systematic review

Background: The COVID-19 pandemic is still ongoing, with rapidly increasing cases all over the world, and the emerging issue of post COVID-19 (or Long COVID-19) condition is impacting the occupational world. Objective: The aim of this systematic review was to evaluate the impact of lasting COVID-19 symptoms or disability on the working population upon their return to employment. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statements we performed a systematic review in December 2021, screening three databases (PubMed, ISI Web of Knowledge, Scopus), for articles investigating return to work in patients that were previously hospitalized due to COVID-19. A hand-searched was then performed through the references of the included systematic review. A quality assessment was performed on the included studies. Results: Out of the 263 articles found through the initial search, 11 studies were included in this systematic review. The selected studies were divided based on follow-up time, in two months follow-up, follow-up between two and six months, and six months follow-up. All the studies highlighted an important impact of post COVID-19 condition in returning to work after being hospitalized, with differences based on follow-up time, home Country and mean/median age of the sample considered. Conclusions: This review highlighted post COVID-19 condition as a rising problem in occupational medicine, with consequences on workers' quality of life and productivity. The role of occupational physicians could be essential in applying limitations to work duties or hours and facilitating the return to employment in workers with a post COVID-19 condition

The Assessment of the Ethical Organizational Culture: Validation of an Italian Short Version of the Corporate Ethical Virtues Model Based Questionnaire

Background: In the context of the relationship between work and ethics, it is essential to be able to analyse the Ethical Organizational Culture of the work environment through the use of multidimensional tools. The lack of validated tools on the Italian population led us to develop a short Italian version of the Kaptein’s Corporate Ethical Virtues Model. The purpose of this study is to validate this tool to be used in Italy, in public administration notably. Methods: Within an assessment campaign of the working conditions of the operators (all 10422 white collar employees) of an Italian Public Administration for the purposes of welfare and safety of working conditions we performed a validation study. At the time of the survey, an exploratory factor analysis was carried out by selecting the items on the basis of factor loads. We used the Cronbach’s alpha coefficients to evaluate the internal consistency. Confirmatory factor analysis was conducted to assess the goodness-of-fit of the latent structure underlying the ethical culture indicators. Results: In the exploratory factor analysis out of 690 questionnaires, 405 (59%) were filled out; we selected 24 items with a load factor between 0.61 and 0.92. The internal consistency was good (α=0.917). In the confirmatory factor analysis, out of 5497 questionnaires, 3706 (67%) were filled out; the confirmatory factor analysis model showed an excellent adaptation of the model of the eight-dimensional structure of the 24-item questionnaire (RMSEA=0.052 [90%CI 0.050-0.054], CFI=0.96, TLI=0.95). Conclusion: The Italian short version of the Corporate Ethical Virtues Model based Questionnaire demonstrated good psychometric properties. In Italy the adapted questionnaire has evidence of its validity and reliability to be used in further studies and to be able to conduct surveys on ethical climate about companies and to foster actions to improve working conditions in relation to ethics

Italian health care workers and Adverse skin reactions to personal protective equipment during Covid-19 pandemic

Introduction: During the pandemic, the use of personal protective equipment (PPE) has become essential for Healthcare Workers (HCWs) to fight safely against the virus. However, the extensive and prolonged use of PPE may cause various adverse skin reactions due to the use of alcohol hand cleanser and protracted use of masks and goggles. The aim of this study is to evaluate the skin problems caused by PPE in HCWs and the possible consequences on their work. Materials and methods: An online ad hoc questionnaire, composed by 35 questions about sociodemographic characteristics, work related issues and exposure/habits about PPE, was administered to a sample of Italian HCWs. Univariate and multivariate analyses were performed in order to explore possible associations between variables. Results: We tested 3 types of PPE: Gloves, Hair Bonnets and Masks for different time of utilization (<1, 1-3, 3-6, >6 hours). The sample included 1184 participants: 292 workers reported a dermatological pathology nested in four different pathological groups: 45 (15%) had Psoriasis, 54 (19%) Eczema, 38 (13%) Acne, 48 (16%), seborrheic dermatitis and 107 (36%) other. 25 workers had a loss of occupational days due to dermatological illness; 56 occupational physician surveillance visits were asked for; in 30 cases were recognized limitations in working duties. Conclusions: Protecting HCWs requires the use of PPE, but occupational dermatitis is an emerging problem in the midst of the COVID-19 pandemic. National data for affected healthcare professionals could contribute to a better understanding of the problem and prevention initiatives in the workplace

COVID-19 Vaccination and Medical Liability: An International Perspective in 18 Countries

The COVID-19 vaccination has proven to be the most effective prevention measure, reducing deaths and hospitalizations and allowing, in combination with non-pharmacological interventions, the pandemic to be tackled. Although most of the adverse reactions to vaccination present mild symptoms and serious effects are very rare, they can be the cause of legal action against the healthcare workers (HCWs) who administered it. To highlight differences in the medical liability systems, we performed a search for the three most populous countries in each continent on vaccine injury compensation programs, new laws or policies to protect HCWs administering vaccinations introduced during the COVID-19 pandemic, and policies on mandatory vaccinations, on literature databases and institutional sites. We found that in seven countries the medical liability system is based on Common Law, while in eleven it is mainly based on Civil Law. Considering the application of specific laws to protect HCWs who vaccinate during the pandemic, only the USA and Canada provided immunity from liability. Among the countries we analyzed, fourteen have adopted compensation funds. From an international perspective, our results highlight that in eleven (61.1%) countries medical liability is mainly based on Civil Law, whilst in seven (38.9%) it is based on Common Law

Nutritional status and quality of life in adults undergoing allogeneic hematopoietic stem cell transplantation

Although the effects of malnutrition on morbidity and mortality in adult patients undergoing allogeneic hematopoietic stem cell transplantation are clear, the relationship with quality of life (QOL) is less clear. The purpose of this study was to assess the relationship between malnutrition and QOL. A prospective observational study was conducted in 36 adult patients undergoing allogeneic hematopoietic stem cell transplantation. Adapted criteria of the Global Leadership Initiative on malnutrition have been used for the diagnosis of malnutrition in clinical settings. A cancer linear analog scale was used to assess QOL. Overall QOL at 14 days after allogeneic hematopoietic stem cell transplantation was 37.1 (95% CI 2.9–45.39) in patients without severe malnutrition, versus 16.0 (95% CI − 6.6 to 38.6) in patients with severe malnutrition (p = 0.05). At discharge, it was 48.0 (95% CI 38.4–57.6) versus 34.0 (95% CI 4.1–63.9) (p = 0.27). The results of our study suggest that patients with severe malnutrition at discharge tend to have worse QOL. A larger cohort of patients is required to confirm this hypothesis

Medical Liability of the Vaccinating Doctor: Comparing Policies in European Union Countries during the COVID-19 Pandemic

In 2020, the COVID-19 pandemic exhausted healthcare systems around the world, including European Union countries, with healthcare workers at the frontline. Therefore, new health laws and policies have been introduced at the national level in order to offer greater legal protection for health workers. Since the introduction of COVID-19 vaccination, it has led to the development of specific laws to define the compulsoriness for particular categories. This review aimed to evaluate the system of medical liability, focusing on the ten countries of the European Union with the highest rate of vaccination coverage against SARS-CoV-2. A country-by-country analysis was conducted on the different medical liability systems of individual professionals, in general, and with specific focus on the vaccinating doctors. Additional search was conducted to investigate which European states have introduced specific policies in this field, to identify the implementation of any new laws alongside the COVID-19 vaccination campaigns, and to assess which countries have adopted the European Digital COVID Certificate and funded specific compensation programs for COVID-19 vaccination. Our results highlight an extremely fragmented European scenario; therefore, this work could be a starting point to define a common approach for medical liability and related policies in the COVID-19 pandemic