La misurazione e la gestione del Rischio Sanitario Attraverso Indicatori Idonei e La Formazione Attraverso la Simulazione: Un Approccio Interdisciplinare

Nell’ambito di un progetto di ricerca finanziato dall’AILUN (www.ailun.it) e condotto presso gli ospedali “San Francesco” di Nuoro e “San Camillo” di Sorgono (NU), il gruppo di ricerca ha elaborato appositi questionari riguardanti i profili di rischiosità dei quattro reparti (chirurgia generale, ostetricia e ginecologia, pediatria e neonatologia e anestesia e rianimazione) coinvolti nel progetto. Tali questionari sono stati predisposti tenendo conto della casistica giurisprudenziale e dei riferimenti normativi vigenti. I questionari sono stati poi somministrati, nel corso del 2015, ai medici e al personale sanitario coinvolti nello studio. Un primo obiettivo dei questionari è l’implementazione di strumenti di auto-analisi da parte della struttura sanitaria ed in particolare dei reparti coinvolti nello studio, in modo da consentire al personale ed all’azienda di conoscere il proprio livello di esposizione al rischio. Partendo dal caso di studio in esame, l’obiettivo è elaborare un modello che sia replicabile a livello generale

Un tentativo di misurazione dei rischi sanitari attraverso indicatori idonei: il contesto dello Asl n.3 di Nuoro

Nel saggio il gruppo di ricerca si sofferma sull’identificazione delle aree di principale criticità nelle quattro UU.OO. coinvolte nel progetto dal punto di vista del rischio percepito. L’obiettivo è verificare se sussista una divergenza tra risk assessment e risk perception e di elaborare eventi formativi con l’uso delle tecniche di simulazione finalizzati alla prevenzione-controllo-contrasto delle infezioni ospedaliere.In the essay the research group focuses its attention on identifying the main problematic areas in the four wards which have been involved in the project, taking into account mainly professionals’ risk perception. The objective is to verify whether there is a difference between risk perception and risk assessment and to prepare training programs using simulation techniques aimed at preventing-contrasting-controlling hospital infections

Comparison of γ-aminobutyric acid and biogenic amine content of different types of ewe’s milk cheese produced in Sardinia, Italy

The bioactive compounds γ-aminobutyric acid (GABA) and biogenic amines (BA), together with protein-free amino acids, were measured by high-performance liquid chromatography in ewe’s milk cheeses produced in Sardinia with different technological traits. The study included three types of cheese: Pecorino Sardo PDO, Pecorino and Casu Marzu. Farmhouse Casu Marzu and Pecorino showed GABA content (maximum levels: 1001.3 and 378.1 mg 100 g^–1 respectively) that had never been found so high in cheese before, suggesting that these types of cheese present ideal conditions to produce GABA. These two types of cheese also showed high levels of BA (their total maximum levels were 1035.7 and 288.0 mg 100 g^–1 respectively). Pearson correlation analysis detected significant correlation between GABA and the main BA present in the cheeses (tyramine, cadaverine and putrescine), suggesting that the factors affecting the production of GABA are the same as those influencing BA formation

Ezetimibe added to statin therapy after acute coronary syndromes

BACKGROUND: Statin therapy reduces low-density lipoprotein (LDL) cholesterol levels and the risk of cardiovascular events, but whether the addition of ezetimibe, a nonstatin drug that reduces intestinal cholesterol absorption, can reduce the rate of cardiovascular events further is not known. METHODS: We conducted a double-blind, randomized trial involving 18,144 patients who had been hospitalized for an acute coronary syndrome within the preceding 10 days and had LDL cholesterol levels of 50 to 100 mg per deciliter (1.3 to 2.6 mmol per liter) if they were receiving lipid-lowering therapy or 50 to 125 mg per deciliter (1.3 to 3.2 mmol per liter) if they were not receiving lipid-lowering therapy. The combination of simvastatin (40 mg) and ezetimibe (10 mg) (simvastatin-ezetimibe) was compared with simvastatin (40 mg) and placebo (simvastatin monotherapy). The primary end point was a composite of cardiovascular death, nonfatal myocardial infarction, unstable angina requiring rehospitalization, coronary revascularization ( 6530 days after randomization), or nonfatal stroke. The median follow-up was 6 years. RESULTS: The median time-weighted average LDL cholesterol level during the study was 53.7 mg per deciliter (1.4 mmol per liter) in the simvastatin-ezetimibe group, as compared with 69.5 mg per deciliter (1.8 mmol per liter) in the simvastatin-monotherapy group (P<0.001). The Kaplan-Meier event rate for the primary end point at 7 years was 32.7% in the simvastatin-ezetimibe group, as compared with 34.7% in the simvastatin-monotherapy group (absolute risk difference, 2.0 percentage points; hazard ratio, 0.936; 95% confidence interval, 0.89 to 0.99; P = 0.016). Rates of pre-specified muscle, gallbladder, and hepatic adverse effects and cancer were similar in the two groups. CONCLUSIONS: When added to statin therapy, ezetimibe resulted in incremental lowering of LDL cholesterol levels and improved cardiovascular outcomes. Moreover, lowering LDL cholesterol to levels below previous targets provided additional benefit