The participation of Istituto Superiore di Sanità in the Joint Action on Tobacco Control

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Information retrieval for the Cochrane systematic reviews: the case of breast cancer surgery

Introduction. Systematic reviews are fundamental sources of knowledge on the state-ofthe-art interventions for various clinical problems. One of the essential components incarrying out a systematic review is that of developing a comprehensive literature search.Materials and methods. Three Cochrane systematic reviews published in 2012 wereretrieved using the MeSH descriptor breast neoplasms/surgery, and analyzed with respectto the information sources used and the search strategies adopted. In March 2014, anupdate of one of the reviews retrieved was also considered in the study.Results. The number of databases queried for each review ranged between three andseven. All the reviews reported the search strategies adopted, however some only partially.All the reviews explicitly claimed that the searches applied no language restrictionalthough sources such as the free database Lilacs (in Spanish and Portuguese) wasnot consulted.Conclusion. To improve the quality it is necessary to apply standards in carrying outsystematic reviews (as laid down in the MECIR project). To meet these standards concerningliterature searching, professional information retrieval specialist staff should beinvolved. The peer review committee in charge of evaluating the publication of a systematicreview should also include specialists in information retrieval for assessing the qualityof the literature search

Metabolic Pathways and Potencies of New Fentanyl Analogs

Up to now, little is known about the metabolic pathways of new fentanyl analogs that have recently emerged on the drug markets worldwide with high potential for producing addiction and severe adverse effects including coma and death. For some of the compounds, limited information on the metabolism has been published, however, for others so far no information is available. Considering the well characterized metabolism of the pharmaceutically used opioid fentanyl and the so far available data, the metabolism of the new fentanyl analogs can be anticipated to generally involve reactions like hydrolysis, hydroxylation (and further oxidation steps), N- and O-dealkylation and O-methylation. Furthermore, phase II metabolic reactions can be expected comprising glucuronide or sulfate conjugate formation. When analyzing blood and urine samples of acute intoxication cases or fatalities, the presence of metabolites can be crucial for confirmation of the uptake of such compounds and further interpretation. Here we present a review on the metabolic profiles of new fentanyl analogs responsible for a growing number of severe and fatal intoxications in the United States, Europe, Canada, Australia, and Japan in the last years, as assessed by a systematic search of the scientific literature and official reports

A Helpline Telephone Service for Tobacco Related Issues: The Italian Experience

Antismoking helplines have become an integral part of tobacco control efforts in many countries, including Italy. The demonstrated efficacy and the convenience of telephone based counselling have led to the fast adoption of antismoking helplines. However, information on how these helplines operate in actual practice is not often readily available. This paper provides an overview of the Italian Antismoking Helpline, an increasingly popular telephone service for tobacco problems operating in Italy since 2000. As many states, regions and nations are contemplating various telephone programs as part of large scale anti-tobacco campaigns, this paper briefly discusses the reasons the helpline is well suited to lead the cessation component of a comprehensive tobacco control program, how it operates and how it can be used in conjunction with other tobacco control activities. The Italian Antismoking Helpline provides Italians with free services that include counselling, cessation related information, self help quit kits and current legislation information. The helpline is promoted statewide by media campaigns, health care providers, local tobacco control programs and public school system. The Helpline is centrally operated through the Istituto Superiore di Sanità and it has served over 17.000 tobacco users and others

Impact Factor and other metrics for evaluating science: essentials for public health practitioners.

<p><strong>Abstract</strong>: The quality of scientific evidence is doubly tied with the quality of all research activities that generates<br />it (including the “value” of the scientists involved) and is usually, but not always, reflected in the reporting quality of the scientific publication(s). Public health practitioners, either at research, academic or management levels, should be aware of the current metrics used to assess the quality value of journals, single publications, research projects, research scientists or entire research groups. However, this task is<br />complicated by a vast variety of different metrics and assessment methods. Here we briefly review the most widely used metrics, highlighting the pros and cons of each of them. The rigid application of quantitative metrics to judge the quality of a journal, of a single publication or of a researcher suffers from many negative issues and is prone to many reasonable criticisms. A reasonable way forward could probably be the use of qualitative assessment founded on the indications coming from few but robust quantitative metrics.</p&gt

Ethical and Legal Challenges of Telemedicine in the Era of the COVID-19 Pandemic

Background and objective: Telemedicine or telehealth services has been increasingly practiced in the recent years. During the COVID-19 pandemic, telemedicine turned into and indispensable service in order to avoid contagion between healthcare professionals and patients, involving a growing number of medical disciplines. Nevertheless, at present, several ethical and legal issues related to the practice of these services still remain unsolved and need adequate regulation. This narrative review will give a synthesis of the main ethical and legal issues of telemedicine practice during the COVID-19 pandemic. Material and Methods: A literature search was performed on PubMed using MeSH terms: Telemedicine (which includes Mobile Health or Health, Mobile, mHealth, Telehealth, and eHealth), Ethics, Legislation/Jurisprudence, and COVID-19. These terms were combined into a search string to better identify relevant articles published in the English language from March 2019 to September 2021. Results: Overall, 24 out of the initial 85 articles were considered eligible for this review. Legal and ethical issues concerned important aspects such as: informed consent (information about the risks and benefits of remote therapy) and autonomy (87%), patient privacy (78%) and confidentiality (57%), data protection and security (74%), malpractice and professional liability/integrity (70%), equity of access (30%), quality of care (30%), the professional–patient relationship (22%), and the principle of beneficence or being disposed to act for the benefit of others (13%). Conclusions: The ethical and legal issues related to the practice of telehealth or telemedicine services still need standard and specific rules of application in order to guarantee equitable access, quality of care, sustainable costs, professional liability, respect of patient privacy, data protection, and confidentiality. At present, telemedicine services could be only used as complementary or supplementary tools to the traditional healthcare services. Some indications for medical providers are suggested

Pharmacotoxicology of Non-fentanyl Derived New Synthetic Opioids

A class of opioid agonists not structurally related to fentanyl, derived from research publications of pharmaceutical companies or patents within the United States and abroad are contributing to the current opioid epidemic. Novel synthetic opioids (NSOs) created to circumvent drug control laws such as U-47700, U-49900, AH-7921, or MT-45 have no recognized therapeutic use, are clandestinely manufactured and sold on conventional or dark web. We herein provide a review of the pharmacological properties available on most of these substances trying to provide a better knowledge on these compounds, particularly with respect to toxicity and dangerous adverse effects in users. Indeed, these NSOs share not only a great potency of action and receptor affinity with respect to natural or synthetic opiates (e.g., morphine, heroin, and methadone) but also a non-negligible toxicity leading to intoxications and fatalities, posing a serious harm to public health and society. © 2018 Solimini, Pichini, Pacifici, Busardò and Giorgetti