Применение человеческого эритропоэтина при анемии у больных хирургического профиля

Catedra Chirurgie nr. 1 „Nicolae Anestiadi”, USMF „Nicolae Testemiţanu”Recently, researchers focus attention to “secondary” anemia, caused by chronic somatic diseases. This heterogeneous group of anemia is the most common cause of anemia syndrome occurring in hospitalized patients. The purpose of this study was to study the usefulness of human erythropoietin in surgical patients’ anemia correction. Anemias have one of the most frequently recorded pathological conditions in humans. Despite numerous investigations in this domain, many questions regarding the mechanism of evolutions and disease-modifying therapy remain incompletely deciphered. Erythropoietin, as a physiological regulator of erythrocytes in the blood, is undoubtedly a promising way in the domain. In that article, the authors published the results of using alpha-recombinant human erythropoietin (Repretin) to correct secondary anemia caused by “chronic inflammation” to a group of surgical patients. The term of “chronic inflammation” is generic because, as is known in this group is included acute inflammatory diseases as well as diseases with non-inflammatory character. This group of diseases is characterized by trained and often refractory nature to usual treatment schemes. This material is an original research, which shows promising results.В последнее время внимание исследователей обращено на „вторичные” анемии, вызванные хроническими соматическими заболеваниями. Это гетерогенная группа анемий является наиболее распространенной причиной малокровия у госпитализированных пациентов. Целью данного исследования было изучение целесообразности использования эритропоэтина при анемическом синдроме у больных хирургического профиля. Анемии представляют собой одно из наиболее часто встречающихся патологических состояний у человека. Несмотря на многочисленные исследования в данной области, многие вопросы относительно механизмов, течения и этиопатогенического лечения остаются исследованными не до конца. Эритропоэтин, как физиологический регулятор уровня эритроцитов в крови, несомненно, является перспективным предметом исследования в данной области. В данной статье авторы публикуют результаты использования рекомбинантного человеческого альфа-эритропоэтина (препарата Репретин) для лечения вторичной анемии, вызванной „хроническим воспалением” в группе хирургических больных. Термин „хроническое воспаление” носит общий характер, поскольку, как известно, в эту группу входят острые воспалительные заболевания и заболевания невоспалительного характера. Данная группа заболеваний характеризуется хроническим течением и, зачастую, рефрактерностью к общепринятым схемам лечения

Corporate governance and management practices: stakeholder involvement, quality and sustainability tools adoption: evidences in local public utilities

Local public services is the field in which New Public Management (NPM) and Public Governance (PG) issues are most in evidence. The local public services are characterized by the rethinking of the role played by local government in the provision of services. An evolution has taken place. From a traditional configuration in which local public services were managed by local governments they moved to a configuration where it takes place a separation between the local government role (which continues to be the guarantor of the satisfaction of public needs) and the role of local public utilities (LPUs) (responsible for delivering the services). This transformation implies both the delegation of resources and authority to lower organisational levels within the public sector and the reconfiguration of accountability chains between the state institutions and the society. In recent years, an intense debate has developed regarding the introduction of new tools and control systems. Particular attention has been paid to planning and control systems, human resources management systems, and performance management systems, leaving a few pioneers to develop their analysis on corporate governance mechanisms with regard their relationships with both the external (stakeholders) actors and the internal (management) ones. On one hand, the OECD wrote guidelines in order to ensure good corporate governance practices, focusing on relations with stakeholders. On the other hand, the dialogue between corporate governance and stakeholders has been already tackled by a number of International organizations guidelines or principles, following a debate on corporate governance that has progressively combined a stakeholder perspective with a more classic shareholder-maximizing model of governance. This article contributes at the debate on the stakeholder involvement process. By means of both a theoretical discussion and an empirical research conducted on 37 Italian LPUs, this paper attempts to analyse specific management tools which can be used to improve the quality of corporate governance in LPUs, through the enlargement of the stakeholder involvement. Some NPM’s tools, such as quality standards and sustainability tools imply an effort to offer new forms of organizational behaviour in the decision-making processes (i.e. the choice of the performance indicators and the reporting tools) and may create a dialogue between the enterprise and its stakeholders. In particular, in our study we focus on the adoption of quality standards (ISO 9000 and Customer Satisfaction) and sustainability tools (sustainability reports and ISO 14000 standard) as NPM’s tools to facilitate the stakeholder involvement practices