Infodemiological patterns in searching medication errors: Relationship with risk management and shift work

INTRODUCTION: Western world health care systems have been trying to improve their efficiency and effectiveness in order to respond properly to population aging and non-communicable diseases epidemic. Treatment of the elderly population is becoming complex due to the high number of prescribed drugs because of multimorbidity. Errors in drugs administration in different health care related settings are an actual important issue due to different causes. Aim of this observational study is to measure the online interest in seeking medication errors information related to risk management and shift work. MATERIALS AND METHODS: We investigated Google Trends® for popular search relating to medication errors, risk management and shift work. Relative search volumes (RSVs) were evaluated from 2008 to 2018. A comparison between RSV curves related to medication errors, risk management and shift work was carried out. Then, we compared the world to Italian search. RESULTS: RSVs were persistently higher for risk management than for medication errors (mean RSVs 069 vs. 48%) and RSVs were stably higher for medication errors than shift work (mean RSVs 48 vs. 22%). In Italy, RSVs were much lower compared to the rest of the world, and RSVs for medication errors during the study period were negligible. Mean RSVs for risk management and shift work were 3 and 25%, respectively. RSVs related to medication errors and clinical risk management were correlated (r=0.520, p<0.0001). CONCLUSIONS: Google Trends® search query volumes related to medication errors, risk management and shift work are different. RSVs for risk management are higher, and they are correlated with medication errors. Also, shift work search appears to be lower. These results should be interpreted in order to correctly evaluate how to decrease the number of medication errors in different health care related setting

Measuring knowledge, attitudes and behavior of nurses in medication management. Cross-cultural comparisons in Italy and Malta

Medication errors are one of the most common causes of negative events affecting patient safety all over the world.  Scientific literature divides the factors that contribute to the occurrence of harmful events into factors related to the characteristics of the healthcare workers and factors related to the organization of the drug management process. The aim of the study was to examine the knowledge, attitudes and behaviours related to medication errors among Italian and Maltese nurses

Inflammatory polyradiculoneuropathies: Clinical and immunological aspects, current therapies, and future perspectives

Inflammatory polyradiculoneuropathies are heterogeneous disorders characterized by immune-mediated leukocyte infiltration of peripheral nerves and nerve roots leading to demyelination or axonal degeneration or both. Inflammatory polyradiculoneuropathies can be divided into acute and chronic: Guillain–Barré syndrome and chronic inflammatory demyelinating polyneuropathy and their variants. Despite major advances in immunology and molecular biology have been made in the last years, the pathogenesis of these disorders is not completely understood. This review summarizes the current literature of the clinical features and pathogenic mechanisms of inflammatory polyradiculoneuropathies and focuses on current therapies and new potential treatment for the future

A rapid review of time management strategies among nurse managers

Background: Time management practice is the act of influencing one's behavioural dimensions to complete as many tasks as possible within a specified amount of time. These behavioural dimensions include work organization and the continued application of time management techniques. Good time management, such as setting goals and priorities, as well as planning and delegating tasks, can facilitate productivity and success, contributing to work effectiveness, maintaining balance and job satisfaction. Conversely, poor time management has been associated with poor quality of work, low productivity, negative influence on the career path, and high levels of stress. Aim: The study aims to identify the strategies used by middle nurse managers in time management. Methods: A rapid review of biomedical databases was undertaken during the month of June 2021. The included studies were published in English and in Italian. Results: Findings reveal that the most used and effective time management strategies for nurse managers are setting goals, and priorities and delegating tasks. Other useful strategies also found to be fundamental are discussed in detail. Conclusion: A manager should prioritize the concept of planning, which can be counted as an efficient time management technique and educate himself on delegating. Time management has an impact not only on productivity and organizational success, but also on the balance between private and working life of managers

Changes in anthropometric, biochemical, hematological, hormonal and cardiac markers in a group of late-adult amateur cyclist, afet continuous and prolonged exercise on an uncontrolled diet

Abstract: Purpose: to describe and compare the main biochemical and hematological parameters, markers of cardiac and stress suffering (cortisol), in an amateur group of 8 late-adult cyclists (average age 60.9 years s.d. 4.1 years) before and after a continuous bicycle course of 9 days with an actual duration of 7 days and a daily average of 103.5 Km (total of 725 km) on an uncontrolled diet. Results: body weight, BMI, systolic and diastolic pressure did not vary significantly in pre- and post-cycling performance (p> 0.05). There was no significant change in the pre- and post-red blood cell count in the hemochromocytometric hematological parameters (p = 0.57), while hemoglobin values decreased significantly after pedaling (p = 0.03), as did the average cellular hemoglobin values and the average cell concentration of hemoglobin (p = 0.002 and p = 0.0006, respectively). The number of platelets, white blood cells, the absolute number of neutrophils, lymphocytes, eosinophils, basophils and monocytes, and the percentage of neutrophils, eosinophilic lymphocytes, basophils and monocytes did not change significantly (p> 0.05). With regard to basic biochemistry, there was no significant variation in the values of glucose, urea, creatinine, alanine amino transferase, alkaline phosphatase, cholinesterase and creatinine kinase (p> 0.05). Aspartate amino transferase was found to be significantly greater after pedaling (p = 0.03). The values of albumin, total proteins, lactate dehydrogenase, total calcium, inorganic phosphorus, total magnesium, total iron, sodium and potassium were statistically non-significant between pre and post phases. The lipid profile, total cholesterol, triglycerides, lipases, HDL and LDL were also statistically non-significant even if HDL values increased on average after cycling performance (before 48.9 \ub1 9.5 and after 53.8 \ub1 12.4) while LDL values decreased on average (before 118.5 \ub1 28.8 and after 101.6 \ub1 10.3). In the hormone-labeling and vitamin group, ferritin was statistically non-significant. Pre and post changes in the stress hormone cortisol, PSA, vitamin B12 and natriuretic B-type NT-proBNP peptide were statistically non-significant. Instead, folate decreased significantly following the cycling performance (p = 0.017). In protein biochemistry, apolipoprotein A1 was statistically significant (p = 0.038) increasing after pedaling, while apolipoprotein B, C-reactive protein and transferrin were statistically non-significant. CK MB mass and troponin I in the cardiac markers did not undergo significant changes between pre and post phases. Conclusions: despite the small size of the chosen sample, parameters analyzed between pre and post continuous physical effort lead to the conclusion and confirmation of many data in the literature and, that is, that sporting activity conducted in an important way can improve the biochemical/functional state and, therefore, the health of practising subjects even in late adults and/or the elderly. This could postpone physical psychic decline caused by the natural progression of years

Triple simultaneus oral squamous cell carcinoma in a heavy smoker patient: a case report

Introduction. The presence of multiple malignancies in the aerodigestive tract is a rare disorder defined as multiple primary carcinoma (MPC)1, which lesions must be at different sites separated by normal mucosa and histologically confirmed, and should not be metastatic disease from the index carcinoma2. The reported incidence of MPC in the oral cavity has been reported to be 1.4%. MPC can be simultaneous (diagnosed at the same time as the index tumour), synchronous (additional primaries diagnosed within 6 months of the index tumour), or metachronous (primaries that develop more than 6 months after the index tumour)2. Case report. A 79-year-old edentulous male patient presented 3 different oral lesions: a) an erythro/leukoplasic le- sion on the soft palate and uvula (2,5x1cm), b) a verrucous/ulcerative lesion on the floor of the mouth (1x1cm), c) an exophytic/ulcerative lesion on the edentulus ridge of the 4th sextant (3,5x1cm). Lesions were not associated to any symptoms; the lesions b and c were bleeding and fixed to the underlying tissue. The patient reported no health concerns; he referred a 10-pack-year of cigarettes history followed by 50-pack-year of cigars. All the lesions presented a dark royal blue aspect after the toluidine blue staining3. Incisional biopsies were made and the histological examination reported a diagnosis of “oral squamous cell carcino- ma” in each of the tissue samples. Patient was referred to the Department of Oral Maxillofacial and Plastic Surgery for the TNM staging and the management. Conclusion. The MPC pathogenesis is uncertain involving genetic susceptibility, tumor immunity and environmental factors. Moreover, multiple cancers have a poor prognosis, 3-year survival rate of 50%, underlining that secondary prevention should be promoted and supported in adult heavy smokers, as the early diagnosis of oral carcinoma aris- es the probability of successful treatment

Median-to-ulnar nerve communication in carpal tunnel syndrome: An electrophysiological study

The median-to-ulnar communicating branch (MUC) is an asymptomatic variant of the upper limb innervation that can lead to interpretation errors in routine nerve conduction studies. The diagnosis of carpal tunnel syndrome (CTS) or ulnar nerve lesions can be complicated by the presence of MUC. In this study, we describe electrophysiological features of MUC in CTS patients presenting to our clinic. We enrolled MUB cases from consecutive CTS patients referred to our laboratory between the years 2014 and 2019. MUC was present in 53 limbs (36 patients) from the studied population. MUC was bilateral in 53% of patients. MUC type II was the most common subtype (74%), followed by types III and I; more coexisting MUC types were found in the majority of tested limbs. A positive correlation was demonstrated between the severity of CTS and the presence of positive onset, faster CV, or a double component of the compound muscle action potentials. We emphasize the importance of suspecting the presence of MUC in CTS in the presence of a positive onset or a double component in routine motor conduction studies

Improving sleep quality in cancer patients. a literature review on non-pharmacologic interventions

Objective: Disrupted sleep-in cancer patients is due to several factors. Pre-existing sleep disorders, mental status in cancer, or side effects of cancer treatment are all potential predictors of sleep disturbances in this vulnerable population. This review aims to evaluate and synthesise non-pharmaco-logic interventions for improving sleep quality and the associated benefits in cancer patients. Materials and Methods: A literature review was performed according to PRISMA guidelines. PubMed, Google Scholar, MEDLINE, CINAHL, and Embase databases were interrogated, selected the article with cancer, neoplasm, oncology, sleep-wake disorders, sleep disturbance, sleep problem, strategies, treat-ment, and intervention such as keywords. No time and geographic restrictions but paediatrics, children, and interventions unrelated to sleep improvement in cancer were excluded. Results: Overall, twenty-nine articles were included in the review after selection. The included studies analysed different types of cancer, like breast, lung, and prostate cancer and acute leukaemia. Most of the data gathered from the relevant research suggest that nonpharmacologic interventions significantly improved cancer patients’ sleep quality. Conclusions: Cancer survival rates are increasing; researchers and healthcare professionals should aim not just at survival but also to allow cancer patients just comfortably to live, considering the best quality of life possible. Nurses have a crucial role in the care of this patient population. Nursing implies an intimate relationship with patients and educating the patient to improve their mental and physical condition through non-pharmacological approaches, which should be considered a specific competence

Peripheral giant cell granuloma: immunohistochemical analysis of different markers. Study of three cases

El granuloma periférico de células gigantes (GPCG) es una lesión de tejido blando no neoplásica ocasionada por una reacción hiperplásica a consecuencia de un traumatismo o inflamación. Es una lesión reactiva del tejido blando que se desarrolla exclusivamente en la cavidad oral y con una ligera predilección en el sexo femenino. La localización habitual de GPCG es en la región de los premolares y la mucosa de la cresta alveolar edéntula. Se presentan tres casos con GPCG (dos hombres y una mujer) con una edad comprendida entre los 25 y 35 años. Todos los pacientes se trataron con resección quirúrgica y ninguno sufrió recidivas. Con el propósito de determinar el posible origen de las células estromales mononucleares y de las células gigantes multinucleares, las muestras de cada caso se estudiaron mediante inmunohistoquímica (marcadores CD-68, CD-34 y α-1 antitripsina) con el fin de evaluar la expresión del linaje endotelial y del linaje monocito/macrófago. Los resultados inmunohistoquímicos mostraron una marcada positividad difusa de CD-68 en las células estromales mononucleares y en las células gigantes multinucleadas. Estas últimas resultaron ser inmunonegativas para CD-34 y sólo puntualmente positivas para α-1 antitripsina. Estos resultados sugieren que las cιlulas gigantes multinucleares poseen un fenotipo osteoclαstico, proviniendo del linaje monocito/macrσfago, y que no derivan del linaje de las células endoteliales de los capilares. Se establece la importancia de un exhaustivo diagnóstico y de una exéresis quirúrgica completa de la lesión (curetaje óseo) con el propósito de evitar la reabsorción del diente y hueso adyacente

Fibrolipoma gigante de la mejilla: a propósito de un caso

El fibrolipoma es una neoplasia de origen mesenquimal, rara en la cavidad oral, representando el 1% de todos los tumores benignos orales. Es una variante histológica del lipoma simple, que normalmente se manifiesta a nivel de la mucosa oral, suelo de la boca, lengua y labios. La etiología suele ser traumática cuando afecta localizaciones extraorales, mientras se considera idiopática al manifestarse a nivel bucal. En este artículo se presenta un raro caso de fibrolipoma de mejilla, y se discuten los aspectos diagnósticos, histo-patológicos y de tratamiento de acuerdo a la literatura. Lipomas are common soft tissue mesenchymal neoplasms, rare in the oral cavity, representing 1% of all benign oral tumors. Fibrolipoma is a histological variant of the classic lipoma which normally affects buccal mucosa, floor of the mouth, tongue and lips. In this article is presented a rare case of fibrolipoma of the cheek and are discussed all the aspects of diagnosis, histology and surgical treatment, according to literature data