gender and quality of life in laryngectomized patients

Background: the aim of this study was to investigate possible correlations between the perception of postoperative quality of life and gender. Methods: the questionnaires “the Brief illness Perception Questionnaire” (B-iPQ) and “Voice handicap index” (Vhi) were administered to 94 patients divided into two groups according to gender group a: 73 men, group B: 21 women. RESULTS: The results showed that gender should be considered a factor influencing perceived quality of life in laryngectomized patients. Specifically, women showed greater concern towards the disease, its evolution, and the consequences on their lives, compared to men. CONCLUSIONS: the care of the laryngectomized woman should consider the impact that loss of voice has on the perception of her femininity, and the physical, functional, and above all emotional issues that such surgeries may lead to for women

Post-operative oncological and psychological evaluation of patients with colostomy for colorectal cancer.

BACKGROUND: The therapeutic arsenal for colorectal cancer is largely made up of surgery. In digestive tumors, ostomy devices induce loss of function and control. This medical device generates changes that affect all aspects of patients’ lives. This study evaluates the postoperative follow-up from the oncological point of view and the psychological impact of colosto- my on the quality of life of patients with colorectal cancer, analyzing any complications or relapses, and the high risk of self-concept disorder and social isolation. METHODS: The aim of the work was to identify all the surgeries for colorectal cancer performed in the Federico II University Hospital of Naples, from 2018 to 2021, and among them how many had been packaged a colostomy. We then analyzed how many patients had been evaluated 12 months after surgery, with a transanal endoscopy or transto- my, and the percentage of any complications or relapses. The same patients who underwent endoscopic control were also evaluated psychologically, to analyze how they lived the packaging of the ostomy and how it had affected the quality of life. READ-ONLY COP RESULTS: At endoscopic control, diversion colitis phenomena and few cases of stoma stenosis and stomatitis were detect- PRINTING PROHIBITED ed. No case of neoplastic recurrence. From the psychological point of view, the problems detected were in particular the alteration of body image, the loss of sphincter control, embarrassment and shame for the bad smell, impairment of sex- uality and difficulties in the couple relationship and social contacts, anxiety, depression and loneliness. CONCLUSIONS: The post-operative evaluation of the ostomy patient following colorectal cancer requires endoscopic control to suddenly detect recurrences and complications and psychological support that improves their quality of life

Effects of Cisplatin in Neuroblastoma Rat Cells: Damage to Cellular Organelles

Cisplatin (cisPt) is a chemotherapy agent used as a treatment for several types of cancer. The main cytotoxic effect of cisplatin is generally accepted to be DNA damage. Recently, the mechanism by which cisPt generates the cascade of events involved in the apoptotic process has been demonstrated. In particular it has been shown that some organelles are cisPt target and are involved in cell death. This paper aims to describe the morphological and functional changes of the Golgi apparatus and lysosomes during apoptosis induced in neuronal rat cells (B50) by cisplatin. The results obtained show that the cellular organelles are the target of cisPt, so their damage can induce cell death

Evaluating quality in healthcare organizations: the experience of the performance plan in Lombardy region

In 2011 Lombardy Region introduced a performance measurement, evaluation and accountability system that has to be adopted by all Public Healthcare Organizations operating within its boundaries. The system is based on a performance plan methodology that includes the quality perspective as one of the perspectives needed to evaluate and communicate organizational results. The paper, based on the analysis of all performance plans produced by Lombardy Public Healthcare Organizations highlights the results achieved in terms of: compliance between regional guidelines and organizational practices, and in terms of measures really used in order to evaluate different quality issues

Il performance management negli enti locali

l decreto legislativo 150/09, con il titolo secondo "Misurazione, valutazione e trasparenza della performance", ha messo le amministrazioni pubbliche di fronte a una sfida molto complessa da attuare: adottare in maniera sistemica ed organica le logiche e gli strumenti della gestione orientata alla performance. La complessità di tale sfida deriva, in primo luogo, dalla necessità di tradurre in indicatori quali/quantitativi la gestione degli interessi collettivi e delle relative strategie e politiche degli organi d’indirizzo delle amministrazioni; in secondo luogo, tema non meno problematico, occorre adottare politiche meritocratiche di fronte ad anni di esperienza in cui i sistemi di valutazione sono stati vissuti come meri strumenti retributivi aggiuntivi rispetto allo stipendio di base. In questo quadro, il testo vuole essere una sorta di “vademecum” metodologico per affrontare in modo organico e corretto la progettazione e implementazione di un sistema di performance management, cioè un processo strutturato che consenta di definire e misurare obiettivi, indicatori e target coerenti con le strategie dell’ente e con la relativa declinazione in piani operativi. Il libro, basato anche sulle esperienze operative che hanno visto coinvolti gli Autori negli ultimi due anni, sviluppa con un linguaggio non tecnico la logica generale di definizione di obiettivi, indicatori e target; le modalità di gestione del quadro giuridico e contrattuale; le tecniche e gli schemi operativi per testare la bontà dell’impianto metodologico dei sistemi di misurazione delle performance (schemi e schede per ragionare sugli elementi distintivi di un sistema di misurazione delle performance funzionale alla redazione del Piano della performance sono contenuti nel Cd-Rom allegato); le modalità di rappresentazione delle performance attraverso le prassi applicative del Piano della performance e il corretto processo di valutazione della performance individuale

Strategia, programmazione e valutazione delle performance alla luce del D. Lgs. 150/2009 nei servizi sanitari regionali: modello concettuale ed implicazioni operative

Al fine di supportare i processi di programmazione e valutazione dei risultati conseguiti dai sistemi sanitari nazionali e regionali risulta fondamentale introdurre, nella gestione aziendale, indicatori e strumenti in grado di misurare, valutare e valorizzare le dimensioni delle performance organizzative e individuali. Il modello logico-concettuale presentato in questo contributo, lungi dall’essere una panacea in grado di risolvere tutte le criticità legate alla gestione del ciclo della performance, si propone di essere un tentativo di porre chiarezza all’interno del contesto della riforma in atto, puntando sulle caratteristiche salienti di strumenti manageriali che sono noti e già ampiamente utilizzati in contesti for profit e not for profit. Tuttavia, se, da una parte, vi sono strumenti e metodologie ben noti, dall’altra non sempre i manager hanno la possibilità di utilizzarli al meglio. Occorre, quindi, prestare attenzione alle caratteristiche salienti del proprio modello organizzativo per far sì che vi sia un adattamento progressivo degli strumenti e delle logiche in questione.In order to support the processes of planning and assessment of achievements of national and regional health systems it is essential to introduce, in business management, indicators and tools able to measure, evaluate and enhance the organisational and individual performance. The logicalconceptual model presented in this paper, far from being a panacea able to solve all the problems related to the management of the performance cycle, is proposed to be an attempt to bring clarity to the internal context of the ongoing reform, focusing on the salient features of management tools that are known and already widely used in contexts of ‘for profit’ and ‘not for profit’. However, if, on the one hand, there are tools and methodologies well known by others, not always do managers have the opportunity to use them well. It is, therefore, necessary to pay attention to salient features of their organisational model to be sure that there is a progressive adaptation of the tools and logic in question

Different apoptotic responses and patterns in adhering and floating neoplastic cell cultures: effects of microtubule antagonists

The relationship between apoptotic progression and cell cycle perturbation induced by microtubule-destabilising (vinblastine, Colcemid) and -stabilising (taxol) drugs was studied in two mesenchyme-derived neoplastic cell lines, growing as suspension (Jurkat) and monolayer (SGS/3A) culture, by morphocytochemical and biochemical approaches. The same kind of drug induced different effects on the cell kinetics (proliferation, polyploidisation, death) of the two cell lines. In floating cells, the drugs appeared more effective during the S phase, while in adherent cells they were more effective during the G2/M phase. Moreover two distinct neoplasia-associated apoptotic phenotypes emerged: the first pattern was the typical one and was found in cells with a low transition through the S/G2 phase (Jurkat), and the second one was mainly characterised by a cell death derived from micronucleated and mitotic cells, as a consequence of a low transition through the M/G1 phase (SGS/3A). Our data show that the machinery required for the trigger and progression of apoptosis is present in every cell cycle phase, also in conditions of karyological alterations (aneugenic micronucleations). On the other hand, a different sensitivity of the two microtubular components (interphasic network and mitotic spindle) appears to be related to the anchorage-dependence or -independence during the cell growth disturbances after exposure to antimicrotubular drugs