A new case manager for diabetic patients: a pilot observational study of the role of community pharmacists and pharmacy services in the case management of diabetic patients

The adherence of type 2 diabetes mellitus (DM2) patients with an individual care plan (ICP) is often not satisfactory, nor does it allow for a significant improvement in outcome, because of poor accessibility to services, poor integration of pathway articulations, poor reconciliation with the patient's life, or the lack of a constant reference person. The purpose of this study was to evaluate the contribution of community pharmacists and pharmacy services in improving adherence with periodic controls in DM2. The study was conducted at a rural pharmacy. A sample of 40 patients was calculated with respect to a historical cohort and subsequently enrolled. Clinical and personal data were collected in an electronic case report form. Pharmacists acting as a case manager followed patients carrying out their ICP developed by an attending physician. Some of the activities foreseen by the ICP, such as electrocardiogram, fundus examination, and self-analysis of blood and urine, were carried out directly in the pharmacy by the pharmacist through the use of telemedicine services and point of care units. Activities that could not be performed in the pharmacy were booked by the pharmacist at the accredited units. Examination results were electronically reported by the pharmacist to the attending physician. The primary endpoint was the variation in patient adherence with the ICP compared to a historical cohort. Secondary endpoints were variation in waiting time for the examinations, mean percentage change in glycated hemoglobin (HbA1c) and low-density lipoprotein (LDL) cholesterol levels and blood pressure, impact on healthcare-related costs, and perceived quality of care. Adherence to the ICP significantly increased. Waiting times were reduced and clinical outcomes improved with conceivable effects on costs. Patients appreciated the easier access to services. Community pharmacists and pharmacy services represent ideal actors and context that, integrated in the care network, can really favor ICP adherence and obtain daily morbidity reduction and cost savings through proper disease control and an early diagnosis of complications

Migrantes y comunidades morales: resignificción, etnicidad y redes sociales en Guadalajara (Méjico)

En este trabajo se revisa el concepto clásico de comunidad, recuperando y adaptando el sentido weberiano de la comunidad moral para describir, a través de la comparación de dos casos etnográficos (migrantes alteños y otomíes del estado de Jalisco, Méjico), cómo opera la construcción social de la pertenencia y la identidad -religiosa en un caso y étnica en el otro-, entendidas como conjuntos de elementos significativos que se manifiestan como fronteras simbólicas que amplían o reducen los marcos de pertenencia territorial de ambos. La etnográfía aportada sobre los dos grupos humanos pretende demostrar que ambos se reproducen como comunidades morales mediante la resignificación de los modelos culturales "de" y "en" sus comunidades de origen

Autoinflammatory diseases: a possible cause of thrombosis?

Autoinflammatory diseases are a group of disorders due to acquired or hereditary disfunction of innate immune system and characterized by systemic or localized manifestations. The prototype is Familial Mediterranean Fever, a monogenic hereditary disorder, whose causing gene (MeFV gene) was identified in 1997 and opened the way to a new fascinanting chapter of rheumatology. A growing body of monogenic and poligenic autoinflammatory disorders has been described since then. Arterial and venous thrombosis is a common medical problem, with significant morbidity and mortality. Strong evidences from basic research and clinical epidemiological studies support the theory that inflammation and thrombosis can be associated. Because of their recurrent/chronic inflammatory nature, autoinflammatory diseases are a putative cause of thrombotic manifestations. In the present work, we reviewed the available evidences about monogenic autoinflammatory disorders, complicated by thrombotic manifestations

Il nuovo volto della giustizia penale

I più recenti interventi legislativi hanno contribuito a modificare la fisionomia, sostanziale e processuale, del sistema della Giustizia penale. Nel panorama delle riforme spiccano innanzitutto gli strumenti di contrasto. A venire in rilievo, da un lato, è l'introduzione del delitto di autoriciclaggio ad opera della legge 15 dicembre 2014, n. 186; dall'altro, la configurazione, attraverso il d.l. 18 febbraio 2015, n. 7, convertito con modificazioni in legge 17 aprile 2015, n. 43, di un percorso articolato – di prevenzione e repressione – che aspira a fronteggiare i fenomeni di terrorismo, anche internazionale. Oltre ai tanti snodi ermeneutici posti da tali innesti normativi, il volume affronta anche quelli che emergono dall'intervento di depenalizzazione in concreto e deflazione processuale realizzato mediante l'istituto della «non punibilità per particolare tenuità del fatto» (d.lgs. 16 marzo 2015, n. 28). Entra in campo, poi, l'approfondita disamina delle luci e delle ombre proiettate sul sistema processuale dalle modifiche apportate alla disciplina delle misure cautelari dalla legge 16 aprile 2015, n. 47, ed infine, l'analisi delle ricadute prodotte da tale ultimo provvedimento e dalla legge 23 febbraio 2015, n. 19, sull'ordinamento penitenziario

Synthetic approaches to difluoroindolecarboxylic acid ethyl esters

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Looking for the right balance between human and economic costs during COVID-19 outbreak

Since the beginning of Coronavirus 2019 (COVID-19) disease outbreak, there has been a heated debate about public health measures, as they can presumably reduce human costs in the short term but can negatively impact economies and well-being over a longer period. Materials and methods: To study the relationship between health and economic impact of COVID-19, we conducted a secondary research on Italian regions, combining official data (mortality due to COVID-19 and contractions in value added of production for a month of lockdown). Then, we added the tertiles of the number of people tested for COVID-19 and those of health aids to evaluate the correspondence with the outcome measures. Results: Five regions out of 20, the most industrialized northern regions, which were affected both earlier and more severely by the outbreak, registered both mortality and economic value loss above the overall medians. The southern regions, which were affected later and less severely, had low mortality and less economic impact. Conclusions: Our analysis shows that considering health and economic outcomes in the assessment of response to pandemics offers a bigger picture perspective of the outbreak and could allow policymakers and health managers to choose systemic, 'personalized' strategies, in case of a feared second epidemic wave

Mitotic cell death induction by targeting the mitotic spindle with tubulin-inhibitory indole derivative molecules

Tubulin-targeting molecules are widely used cancer therapeutic agents. They inhibit microtubule-based structures, including the mitotic spindle, ultimately preventing cell division. The final fates of microtubule-inhibited cells are however often heterogeneous and difficult to predict. While recent work has provided insight into the cell response to inhibitors of microtubule dynamics (taxanes), the cell response to tubulin polymerization inhibitors remains less well characterized. Arylthioindoles (ATIs) are recently developed tubulin inhibitors. We previously identified ATI members that effectively inhibit tubulin polymerization in vitro and cancer cell growth in bulk cell viability assays. Here we characterise in depth the response of cancer cell lines to five selected ATIs. We find that all ATIs arrest mitotic progression, yet subsequently yield distinct cell fate profiles in time-lapse recording assays, indicating that molecules endowed with similar tubulin polymerization inhibitory activity in vitro can in fact display differential efficacy in living cells. Individual ATIs induce cytological phenotypes of increasing severity in terms of damage to the mitotic apparatus. That differentially triggers MCL-1 down-regulation and caspase-3 activation, and underlies the terminal fate of treated cells. Collectively, these results contribute to define the cell response to tubulin inhibitors and pinpoint potentially valuable molecules that can increase the molecular diversity of tubulin-targeting agents

“Se Ben Ricordo”: Memoria e Intertesto Nella Commedia di Dante

Este trabalho procura examinar rapidamente o conceito clássico e medieval de memória e sua presença na obra de Dante, na base das riquíssimas relações intertextuais entre a Commedia e a cultura da época. Após um breve panorama da noção de intertexto, são considerados dois exemplos nos quais a própria Commedia se torna intertexto

Traduzir “falsas” traduções: o manuscrito inventado

O topos do manuscrito encontrado aparece na antiguidade clássica, passa pela Renascença e floresce até hoje; esta ficção narrativa, pela qual o texto apresentado seria uma tradução de um imaginário original, levanta ao tradutor real uma série de instigantes questões. O objetivo desta comunicação é promover uma reflexão, analisando alguns exemplos concretos, sobre a tradução destes textos. Os resultados do trabalho demonstrarão como, na nova tradução/metatradução do texto, num jogo de espelhos e suas refrações, aparecem vestígios também de seu imaginário original, formando um palimpsesto das três culturas, uma tripla camada de texto de onde emergem as vozes dos vários autores