Malattia del motoneurone e stress ossidativo: studio in doppio cieco dopo supplementazione alimentare con donatore di curcumina

Lo studio descritto in questa tesi ha previsto l'arruolamento di 46 pazienti affetti da SLA, per valutare l'effetto del tratamento orale con Brainoil su parametri clinici e laboratoristici, tramite uno studio con placebo, in doppio cieco, della durata di 6 mesi

[Policy changes introduced by the national vaccine prevention plan and the mandatory vaccination law of 2017: opinions and attitudes of Italian healthcare workers]

: The Italian National Vaccine Prevention Plan (PNPV) of 2017-19 and subsequent mandatory vaccination law (Law 119/2017) both occurred in the context of a progressive decrease in vaccine coverage levels in Italy and led to important policy changes, including the introduction of new vaccine recommendations and increasing the number of mandatory vaccinations in childhood from four to ten. A survey on a sample of 446 Italian health care workers (HCW) was carried out in order to assess their opinions on policy changes introduced by the PNPV and by the mandatory vaccination law. The convenience sample was selected among participants in a training course on vaccination counselling. The large majority of participants expressed overall satisfaction about the policy changes introduced by the PNPV but some highlighted pitfalls related to its implementation. Moreover, the majority of HCW believe that vaccination coverage for both recommended and mandatory vaccinations has increased thanks to Law 119/2017, therefore expressing a positive attitude towards the enforcement of vaccine mandates

Evaluation of Legionella pneumophila Decrease in Hot Water Network of Four Hospital Buildings after Installation of Electron Time Flow Taps

Legionella spp. control is a critical issue in hospital with old water networks. Chemical disinfection methods are applied as a control measure over prolonged time periods, but Legionella may be resistant to chemical agents in pipeworks with low flow and frequent water stagnation. We evaluated Legionella spp. colonization in the hot water network of Italian hospitals after the installation of time flow taps (TFTs). In the period between 2017 and 2019, TFTs were installed in four hospital water networks. They were programmed in order to obtain a hot water flow of 192 L/day from each TFTs. A continuous chlorination system (chlorine dioxide) and a cold water pre-filtration device were applied in all the buildings. Before and after TFT installation, Legionella spp. was investigated at scheduled times. Before TFT installation, Legionella pneumophila was detected in all the hospitals with counts ranging from 2 × 102 to 1.4 × 105 CFU/L. After TFT installation, a loss in Legionella pneumophila culturability was always achieved in the period between 24 h and 15 days. Total chlorine concentration (Cl2) was detected in the range between 0.23 and 0.36 mg/L while temperature values were from 44.8 to 53.2 °C. TFTs together with chemical disinfection represent a method which improve water quality and disinfectant efficacy, reducing Legionella colonization in dead-end sections

Gly482Ser PGC-1α gene polymorphism and exercise-related oxidative stress in amyotrophic lateral sclerosis patients

The role of exercise in Amyotrophic lateral sclerosis (ALS) pathogenesis is controversial and unclear. Exercise induces a pleiotropic adaptive response in skeletal muscle, largely through the peroxisome proliferator-activated receptor γ coactivator 1α (PGC-1α), a transcriptional coactivator that regulates mitochondrial biogenesis and antioxidant defense mechanisms. It has been suggested that a Gly482Ser substitution in PGC-1α has functional relevance in human disorders and in athletic performance. To test this hypothesis, we examined the genotype distribution of PGC-1α Gly482Ser (1444 G > A) in ALS patients to evaluate whether or not the minor serine-encoding allele 482Ser is involved in oxidative stress responses during physical exercise. We genotyped 197 sporadic ALS patients and 197 healthy controls in order to detect differences in allelic frequencies and genotype distribution between the two groups. A total of 74 ALS patients and 65 controls were then comparatively assessed for plasmatic levels of the oxidative stress biomarkers, advanced oxidation protein products, ferric reducing ability and thiol groups. In addition a subgroup of 35 ALS patients were also assessed for total SOD and catalase plasmatic activity. Finally in 28 ALS patients we evaluated the plasmatic curve of the oxidative stress biomarkers and lactate during an incremental exercise test. No significant differences were observed in the genotype distribution and allelic frequency in ALS patients compared to the controls. We found significant increased advanced oxidation protein products (p A SNP, ALS patients with Gly482Ser allelic variant show increased exercise-related oxidative stress. This thus highlights the possible role of this antioxidant defense transcriptional coactivator in ALS

Ospedale Apuane: approccio Lean alla riprogettazione del percorso chirurgico programmato

Il percorso chirurgico rappresenta il centro di costo più rilevante all’interno dell’ospedale, pertanto è fondamentale una sua organizzazione mirata ad ottenere il massimo ritorno in termini di efficienza, soprattutto in un ospedale in project financing come l’Ospedale Apuane. Lo scopo della tesi è stato quello di analizzare ogni fase del percorso chirurgico tramite un approccio di Lean management, alla ricerca delle principali cause di spreco (rappresentato dalle liste di attesa, dai pazienti inseriti in Lista Operatoria e non operati e dai ritardi delle sedute operatorie), identificando le azioni di miglioramento da adottare al fine di minimizzare le inefficiente individuate. Le due componenti che impattano maggiormente sull’efficienza complessiva del percorso chirurgico sono la programmazione chirurgica e l’organizzazione dei tempi della seduta operatoria. L’efficienza della programmazione chirurgica è stimata con l’indicatore “tasso di interventi cancellati”. È stata avviata una riprogettazione del percorso chirurgico programmato, attraverso una separazione spaziale e temporale di ciascuno step e una pianificazione dei pazienti da preospedalizzare prima dell’approvazione della Nota Operatoria Settimanale, in modo da ridurre i valori dell’indicatore di riferimento e, allo stesso tempo, consentire una “pulizia” delle Liste di Attesa parallela all’attività aziendale di recall. L’efficienza dell’organizzazione della seduta operatoria è stimata dal ritardo nell’inizio del primo intervento in elezione di ciascuna seduta mattutina. Attraverso l’analisi delle motivazioni di ritardo più frequenti e la condivisione delle azioni di miglioramento con tutto il personale coinvolto, con assunzione di responsabilità dello stesso, è stato possibile ottenere un moderato miglioramento sui ritardi

[Policy changes introduced by the national vaccine prevention plan and the mandatory vaccination law of 2017: opinions and attitudes of Italian healthcare workers]

The Italian National Vaccine Prevention Plan (PNPV) of 2017-19 and subsequent mandatory vaccination law (Law 119/2017) both occurred in the context of a progressive decrease in vaccine coverage levels in Italy and led to important policy changes, including the introduction of new vaccine recommendations and increasing the number of mandatory vaccinations in childhood from four to ten. A survey on a sample of 446 Italian health care workers (HCW) was carried out in order to assess their opinions on policy changes introduced by the PNPV and by the mandatory vaccination law. The convenience sample was selected among participants in a training course on vaccination counselling. The large majority of participants expressed overall satisfaction about the policy changes introduced by the PNPV but some highlighted pitfalls related to its implementation. Moreover, the majority of HCW believe that vaccination coverage for both recommended and mandatory vaccinations has increased thanks to Law 119/2017, therefore expressing a positive attitude towards the enforcement of vaccine mandates

Amyotrophic Lateral Sclerosis and Oxidative Stress: a Double-Blind Therapeutic Trial After Curcumin Supplementation

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease that leads to motoneurons degeneration. To date, there is no effective treatment against this disease, so several compounds have been tested aimed to improve the course of ALS, acting on its pathogenic mechanisms. In the last years, a great interest has been dedicated to studying the effects of curcumin, a natural compound that acts modulating mitochondrial functions and oxidative stress