Comparing the Prevalence of Polypharmacy and Potential Drug-Drug Interactions in Nursing Homes and in the Community Dwelling Elderly of Emilia Romagna Region

Backround: We aimed at assessing the prevalence of polypharmacy and potential drug-drug interactions (DDIs) with clinical relevance in elderly patient on Emilia Romagna area. Both outpatients and residents in nursing homes were assessed, with only partially overlapping strategies. Methods: We defined a list of 190 pairs of potentially interacting drugs, based on literature appraisal and availability of therapeutic alternatives. January-June 2018 data on drug use in patients over 65 years-old were collected from nine Local Health Authorities of Emilia Romagna: data on community-dwelling subjects were extracted from archives of reimbursed prescriptions, while drug use in a sample of nursing homes was recorded from clinical charts in one index day within the same semester. The frequency of polypharmacy (at least five or at least 10 concurrent drugs) and of each DDI was calculated. Results: In line with different rates of polypharmacy (80% vs 16%), the risk of exposure to at least one interaction was 53.7% in nursing homes and 26.4% in outpatients. Among DDIs, in nursing homes antidepressants—anxiolytics (11.9%) ranked first, followed by antidepressants—aspirin (7.4%). In outpatients, ACE-inhibitors—non-steroidal anti-inflammatory drugs (NSAIDs) reached 7.2% followed by the calcium channel blockers—α-blockers (2.4%). Discussion: Polypharmacy and risk of DDIs appeared very different in the two settings, due to both technical and clinical reasons. In order to reduce use of benzodiazepines, NSAIDs, antidepressants and relevant DDIs, 1) defining alternative options for pain relief in elderly outpatients, and 2) implementing non-pharmacological management of insomnia and anxiety in nursing homes should be prioritized

Restructuring surgical training after COVID-19 pandemic: A nationwide survey on the Italian scenario on behalf of the Italian polyspecialistic young surgeons society (SPIGC)

Introduction: The COVID-19 pandemic has led to the disruption of surgical training. Lack of communication, guidelines for managing clinical activity as well as concerns for safety in the workplace appeared to be relevant issues. This study aims to investigate how surgical training has been reorganized in Italy, almost 2 years after the outbreak of COVID-19 pandemic. Materials and methods: A 16-item-electronic anonymous questionnaire was designed through SurveyMonkey© web application. This survey was composed of different sections concerning demographic characteristics and impacts of the second COVID-19 pandemic wave on surgical and research/didactic activities. Changes applied in the training programme and activities carried out were also investigated. The survey was carried out in the period between June and October 2021. Results: Four hundred and thirty responses were collected, and 399 were considered eligible to be included in the study analysis. Three hundred and thirty-five respondents continued working in Surgical Units, with a significant reduction (less than one surgical session per week) of surgical sessions in 49.6% of them. With concern to didactic and research activities, 140 residents maintained their usual activity, while 116 reported a reduction. A sub-group analysis on resident moved to COVID-19 departments showed a reduction of research activities in 35% of them. During the period considered in this survey, the surgical training program was not substantially modified for most of participants (74.6%). Conclusion: Our survey demonstrated that surgical residency programs haven't improved 2 years after the beginning of the pandemic. Further improvements are needed to guarantee completeness of surgical training, even in emergency conditions

The molecular logic of endocannabinoid signalling

The endocannabinoids are a family of lipid messengers that engage the cell surface receptors that are targeted by Δ9-tetrahydrocannabinol, the active principle in marijuana (Cannabis). They are made on demand through cleavage of membrane precursors and are involved in various short-range signalling processes. In the brain, they combine with CB1 cannabinoid receptors on axon terminals to regulate ion channel activity and neurotransmitter release. Their ability to modulate synaptic efficacy has a wide range of functional consequences and provides unique therapeutic possibilities. © 2003, Nature Publishing Group. All rights reserved

Indagine nazionale sui tirocini professionalizzanti nei Corsi di Laurea in Tecniche della Prevenzione nell’Ambiente e nei Luoghi di Lavoro (TPALL)

Il tirocinio rappresenta il cuore della preparazione professionale degli studenti dei Corsi di Laurea delle Professioni Sanitarie. Per identificare, descrivere e analizzare le caratteristiche, a livello nazionale, dei tirocini nel Corso di Laurea in Tecniche della Prevenzione nell'Ambiente e nei Luoghi di Lavoro (TPALL) \ue8 stato disegnato uno studio esplorativo di tipo descrittivo, allo scopo di fornire nuove conoscenze sul tema, favorire il confronto tra i formatori e il miglioramento delle attivit\ue0 formative professionalizzanti. \uc8 stato progettato un questionario, applicando le prime fasi del processo di validazione, come indicato in letteratura. L\u2019analisi della validit\ue0 di contenuto \ue8 stata effettuata attraverso il Content Validity Index. Il questionario risultante (50 items) \ue8 stato inviato per la compilazione online ai Direttori delle Attivit\ue0 Didattiche (DAD) delle 33 sedi del Corso di Laurea TPALL attivi nell\u2019a.a. 2016-2017, afferenti a 27 Atenei italiani. Hanno risposto il 78% dei Coordinatori, riportando i dati del 73% delle sedi dei corsi TPALL presenti in Italia, riguardanti il percorso di tirocinio di 1205 studenti. L\u2019indagine ha rilevato una realt\ue0 piuttosto differenziata dalla quale emergono criticit\ue0 connesse al riconoscimento del ruolo delle figure tutoriali, alla progettazione dei percorsi formativi e alla loro valutazione. Da ci\uf2 \ue8 possibile trarre indicazioni per la ricerca di strategie comuni, l\u2019implementazione della formazione delle figure tutoriali e l\u2019arricchimento dell\u2019offerta formativa.Training in the field is considered a core phase in the educational process of healthcare professionals. We designed a National explorative survey to identify and describe the characteristics of the Environmental Health Officers (EHO) apprenticeships in undergraduate courses; our aim was to extend knowledge of this topic, stimulate debate among teachers and promote the improvement of training in the field. We designed a questionnaire, and applied the first phases of the validation process, as pointed out by literature. The analysis of content validity was performed calculating the Content Validity Index. The resulting questionnaire (50 items) was emailed to all the 33 Italian Coordinators of EHO apprenticeships (belonging to 27 different universities) in the A.Y. 2016-2017, for online filling out. Seventy eight% of the Coordinators filled out the questionnaire, reporting data related to 73% of the universities offering EHO courses, which globally involved 1205 students. Our survey revealed a quite patchy situation, in which some critical aspects emerged, mainly related to the acknowledgment of the role of mentors/tutors, and to the activities of planning and evaluating training in the field. Accordingly, we point out the necessity of discussing common strategies to implement EHO apprenticeships on a national basis, to develop mentors\u2019 programs, and, more generally, to improve curricula

PGF2-ALPHA THROMBOXANE-B2 AND HETE LEVELS IN GERBIL BRAIN CORTEX AFTER LIGATION OF COMMON CAROTID ARTERIES AND DECAPITATION

The effects of ligation of both common carotid arteries in the gerbil on the levels of PGF2\u3b1, TXB2, HETE and of energy metabolites in brain cortex, have been investigated. Also, in the same experimental conditions the changes of cyclic AMP in brain cortex, cerebellum, striatum and hippocampus have been monitored. ATP, glycogen, glucose and phosphocreatine decrease whereas, lactate and cyclic AMP are enhanced in the ischemic brain, as previously reported. In contrast, levels of arachidonic acid metabolites are not modified. During ischemia following decapitation, instead, PGF2\u3b1, and TXB2, show considerable increase