292 research outputs found

    PUK9 COST-EFFECTIVENESS OF PARICALCITOL IN THE TREATMENT OF SECONDARY HYPERPARATHYROIDISM: THE EXPERIENCE IN ITALY

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    Cooperative Scattering by Cold Atoms

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    We have studied the interplay between disorder and cooperative scattering for single scattering limit in the presence of a driving laser. Analytical results have been derived and we have observed cooperative scattering effects in a variety of experiments, ranging from thermal atoms in an optical dipole trap, atoms released from a dark MOT and atoms in a BEC, consistent with our theoretical predictions.Comment: submitted for special issue of PQE 201

    Observation of a Cooperative Radiation Force in the Presence of Disorder

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    Cooperative scattering of light by an extended object such as an atomic ensemble or a dielectric sphere is fundamentally different from scattering from many point-like scatterers such as single atoms. Homogeneous distributions tend to scatter cooperatively, whereas fluctuations of the density distribution increase the disorder and suppress cooperativity. In an atomic cloud, the amount of disorder can be tuned via the optical thickness, and its role can be studied via the radiation force exerted by the light on the atomic cloud. Monitoring cold 87Rb^{87}\text{Rb} atoms released from a magneto-optical trap, we present the first experimental signatures of radiation force reduction due to cooperative scattering. The results are in agreement with an analytical expression interpolating between the disorder and the cooperativity-dominated regimes

    Le conseguenze sulla spesa farmaceutica pubblica di un nuovo inibitore di pompa protonica: esomeprazolo

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    Aim of the present study is to check the economic advantage of esomeprazole, a new proton pump inhibitor that suppresses gastric acid secretion. The efficacy and tolerability of esomeprazole have been already demonstrated, now the pharmacoeconomic studies must investigate the possible savings for the SSN in case of esomeprazole immission on the Italian market. In this paper the authors present two pharmacoeconomic evaluations, the first based on cost/efficacy analysis, the second based on cost minimization analysis. For both analyses, the term of comparison is omeprazole, “gold standard” in the treatment of acid reflux-related pathologies. The effect in terms of volumes (DDD) and costs of the introduction of esomeprazole in the italian market has also been simulated

    I costi dell’influenza in Italia

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    The influenza is an acute viral infection that strikes respiratory tract and its diffusion is characteristic of epidemic and pandemic reoccurence. Globally the influenza represents, for the entity of its social impact (measurable in terms of morbility, hospitalization and mortality), a heavy healt care problem. In Italy the estimated incidence is 10-15%: the influenza is the third death cause for infectiuos disease, after AIDS and tubercolosis. This study is based on the Studio 606, the first italian study that allow us to pass from the presumptive phase to the observational one. The Studio 606 has been projected and realized by the Società Italiana di Medicina Generale (SIMG), involving about 200 general practitioners (MMG) in two sample region, Lombardia and Puglia. The study has been developed between December the 15th, 1998 and March the 15th, 1999. The influenza causes especially indirect costs: most of people affected with influenza doesn’t go to work for about five days and these absences create an average cost per capita of £558.000. This indirect cost represents 87% of total average cost of one single influenza event

    Strategies for the introduction and implementation of a guideline for the treatment of type 2 diabetics by general practitioners (GPs) of the Lazio region of Italy (IMPLEMEG study): Protocol for a cluster randomised controlled trial [ISRCTN80116232]

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    BACKGROUND: Despite broad agreement on the necessity to improve quality of diabetic care through implementation of clinical guidelines, in Italy many people with diabetes still lack adequate care in general practice. In addition there is little evidence to support the choice of implementation strategies, especially in the Lazio region (central Italy), where comparative studies among general practitioners (GPs) are uncommon. The primary objective of the study is to assess the effectiveness of different strategies for the implementation of an evidence-based guideline for the management of non-complicated type 2 diabetes mellitus (DM) among GPs of the Lazio region. METHODS/DESIGN: Three-arm cluster-randomised trial (C-RCT). 252 GPs were randomised either to arm 1 (comprising a training module and administration of the guideline), or to arm 2 (administration of guideline without training), or to arm 3 (control arm), continuing current practice. Arm 1 participants attended a two-day course with CME credits. Data collection will be performed using current information systems. Patients' health data was also collected to describe diabetic populations cared for by GP participants. Process outcomes will be measured at the patient level and at the cluster level one year after the intervention. We will assess GPs' adherence to guideline recommendations for diabetes management relative to: 1) pharmacological management of diabetes; 2) pharmacological management of cardiovascular risk factors (hypertension and dislypidaemia); 3) measurement of glycosilated haemoglobin as the principal indicator of glycaemic control; 4) micro- and macrovascular complications assessment tests. Outcomes will be expressed as proportions of patients cared for by GPs who will have prescriptions of drugs, requests for tests and for outpatient appointment visits. To estimate the efficiency of resource use associated with the intervention a cost-effectiveness analysis will be carried out. The design of the study is based on three Cochrane and one Health Technology Assessment systematic reviews of guideline dissemination and implementation strategies

    I costi della sepsi in Italia

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    The aim of this study is to evaluate additional hospitalisation costs and intangible costs (mortality) in patients with sepsis (intended as severe sepsis or sepsis shock) in Italy. The evaluation is based on clinical data from the Italian Sepsis Study, a prospective, multicentre study conducted in 99 Intensive Care Units (ICUs)located across Italy. Each ICU enrolled the first two (or three) patients admitted each month, during the year April 1993 to March 1994. In particular, data collected included the Average Length Of Stay (ALOS) in ICU and later in the regular ward, and the mortality within four weeks and in hospital. Out of the 2,946 patients enrolled, 2,641 never developed sepsis and were considered as the control group (comparability was confirmed based on gender, age, and comorbidity). The additional (respective to the control group) ALOSs of the patients with sepsis were valued in monetary terms using per diem full costs, inflated to 2000: 1,033.43 Euro for l day in ICU (published data) and 299.54 Euro for l day in the regular ward (estimated data based on published materials). Statistical significance was tested with Student t test. The hospitalisation cost of a patient with sepsis (21,571.88 Euro) is significantly higher (+86%) than that patient without sepsis (11,590.84 Euro), due to a longer (+ 163%) stay in the expensive ICU, not balanced by shorter stay in the regular ward. Also intangible costs are significantly higher: the risk for an ICU patient with sepsis to die in hospital is 3 times higher than that of an ICU patient without sepsis. In particular, those patients developing sepsis after admission are more costly and with a higher mortality risk

    A practical algorithmic approach to mature aggressive B cell lymphoma diagnosis in the double/triple hit era. Selecting cases, matching clinical benefit. A position paper from the Italian Group of Haematopathology (G.I.E.)

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    An accurate diagnosis of clinically distinct subgroups of aggressive mature B cell lymphomas is crucial for the choice of proper treatment. Presently, precise recognition of these disorders relies on the combination of morphological, immunophenotypical, and cytogenetic/molecular features. The diagnostic workup in such situations implies the application of costly and time-consuming analyses, which are not always required, since an intensified treatment option is reasonably reserved to fit patients. The Italian Group of Haematopathology proposes herein a practical algorithm for the diagnosis of aggressive mature B cell lymphomas based on a stepwise approach, aimed to select cases deserving molecular analysis, in order to optimize time and resources still assuring the optimal management for any patient
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