Quality appraisal of documents producing recommendations for breast, colorectal and cervical cancer screening

Background: Breast, cervical, and colorectal cancer screening are evidence-based interventions recommended by most governmental agencies and scientific societies. The aim of this review is to assess the quality of guidelines on screening and to describe differences according to the context in which they were produced. Methods: A literature search of the main databases, websites on health care, and guidelines, as well as the websites of several scientific societies was carried out in order to identify the most recent guidelines (since 2000) on cervical, breast, and colorectal cancer screening. Only documents written in Italian or English were included. Two investigators independently assessed quality by using the AGREE (Appraisal of Guidelines, Research and Evaluation in Europe) instrument. Results: Thirty-three, 32, and 18 relevant documents for cervical, breast, and colorectal cancer, respectively, were identified. Only some documents (19, 12 and 13 for cervical, breast, and colorectal cancer, respectively) could be evaluated with AGREE. Items included in the domain “scope and purpose” obtained the highest scores, followed by “clarity of presentation” domain, while “applicability”, “patient involvement,” and “conflict of interest disclosure” domains obtained the lowest scores. The quality did not improve in more recent documents. Documents produced by governmental agencies, on average, had higher scores than documents by scientific societies, particularly for “stakeholder involvement” and “applicability”. Conclusions: Documents from different countries and health systems differ in terms of the main recommendations given and in the quality of the documents. Those produced by governmental agencies have a more multidisciplinary authorship and pay more attention to applicability than do those produced by scientific societies

Road traffic injuries in one local health unit in the Lazio region: results of a surveillance system integrating police and health data

<p>Abstract</p> <p>Objective</p> <p>Different sources are available for the surveillance of Road Traffic injuries (RTI), but studied individually they present several limits. In this paper we present the results of a surveillance integrating healthcare data with the data gathered by the municipal police in the southeastern area of Rome (630,000 inhabitants) during the year 2003.</p> <p>Methods</p> <p>The Municipal police RTI reports, which list the exact location, circumstances and some risk factor of the crash, were searched in the emergency visit, hospitalization and mortality databases, to integrate them with the information on health consequences.</p> <p>A multivariate analysis was conducted to evaluate risk factors (crash circumstances, age ad gender of the casualty) associated with hospital admission following a RTI.</p> <p>Mapping of RTI locations was created. The locations with higher risk of accidents with severe health consequences and at higher risk for pedestrians were identified.</p> <p>Results</p> <p>According to police records 4571 RTI occurred in 2003, 75% of which led to emergency department admissions. Sixteen percent of these emergency visits ended in hospitalization, and 44 deaths were reported within 30 days of the event, most of which occurred in young men.</p> <p>The people with the highest risk of hospitalization after an RTI were the cyclists, pedestrians and followed by people on two-wheeled vehicles. The type of crash with the highest risk of hospitalization was head-on collision.</p> <p>Geographical analyses showed four clusters with higher severity of RTI. Specific attention was paid to pedestrian injuries. Analyzing the locations of RTIs involving pedestrians permitted us to rank the most dangerous streets. The roads at high risk for pedestrians identified problems in the bus stop constructions and in the placement of the zebra pedestrian crossings.</p> <p>Conclusion</p> <p>This study proves the feasibility of an integrated surveillance system of RTI by using routinely collected local data. The high-risk locations identified with the geographic analyses method in this study highlighted infrastructural problems, suggesting immediate preventive interventions.</p

El saber didáctico

Fil: Cols, Estela Beatriz. Universidad Nacional de La Plata. Facultad de Humanidades y Ciencias de la Educación; Argentina

Planning the management of water resources in the context of climate change. An application to the Comahue region, Patagonia , Argentina

El presente trabajo muestra la aplicación de una metodología para el diagnóstico de un sistema hídrico complejo y extenso, la cual facilita la toma de decisiones robustas de largo plazo en un contexto de elevada incertidumbre tanto climática como no climática. Para ello se modela y se evalúa la ocurrencia de potenciales fallas en el sistema hídrico constituido por las cuencas de los ríos Limay, Neuquén y Negro en la Patagonia Argentina, para múltiples escenarios a lo largo del periodo 2010-2050. Dicha evaluación se realiza utilizando el software WEAP7 y tomando en cuenta diversas incertezas que se presentan hacia el futuro (e.g. el clima, la evolución de la superficie bajo riego y del tipo de cultivos), y posibles alternativas de intervención (e.g. la construcción de centrales hidroeléctricas, la adopción de medidas de eficiencia hídrica en conducción y riego). Los resultados permiten determinar que la construcción de embalses así como la mejora de eficiencia en riego y conducción agrícola (incluyendo la remodelación y / o construcción de infraestructura de riego y drenaje), podrían ser efectivas para mitigar los impactos negativos para la mayor parte de los escenarios climáticos y de superficie bajo riego considerados.The present work shows the application of a tool for the diagnosis of a complex and extensive water system, which facilitates taking robust long term decisions in a context of high climatic and non-climatic uncertainty. In order to do this, the occurrence of potential faults is modeled and evaluated for the water system constituted by the basins of the rivers Limay, Neuquén and Negro in the Patagonia Argentina, for multiple scenarios throughout the period 2010-2050. This evaluation is carried out using WEAP software and taking into account various future uncertainties (e.g. climate, evolution of irrigated land and type of crops), and possible intervention alternatives (e.g. the construction of hydropower plants, the adoption of efficiency measures in water conduction and irrigation). The results show that reservoir construction as well as improved irrigation and agricultural management efficiency (including remodeling and / or construction of irrigation and drainage infrastructure) could be effective in mitigating negative impacts for most climatic and irrigation scenarios under consideration.Fil: Girardin, Leonidas Osvaldo. Fundación Bariloche; ArgentinaFil: Girardin, Osvaldo. Fundación Bariloche; ArgentinaFil: Losano, Fernando. Universidad Nacional del Comahue; ArgentinaFil: Marizza, Marta. Universidad Nacional del Litoral; ArgentinaFil: Cello, Pablo. Universidad Nacional del Litoral; ArgentinaFil: Bucciarelli, Lisandro. Subsecretaría de Recursos Hídricos del Neuquén; ArgentinaFil: Forni, Laura. Stockholm Environment Institute-Davis; SueciaFil: Camilloni, Inés. Universidad de Buenos Aires; ArgentinaFil: Bravo, Gonzalo. Fundación Bariloche; ArgentinaFil: Lallana, Francisco. Fundación Bariloche; ArgentinaFil: Di Sbroiavacca, Nicolas. Fundación Bariloche; Argentin

hERG stereoselective modulation by mexiletine-derived ureas: Molecular docking study, synthesis, and biological evaluation.

Long QT syndrome (LQTS) is a disorder of cardiac electrophysiology resulting in life-threatening arrhythmias; nowadays, only a few drugs are available for the management of LQTS. Focusing our attention on LQT2, one of the most common subtypes of LQTS caused by mutations in the human ether-à-go-go-related gene (hERG), in the present work, the stereoselectivity of the recently discovered mexiletine-derived urea 8 was investigated on the hERG potassium channel. According to preliminary in silico predictions, in vitro studies revealed a stereoselective behavior, with the meso form showing the greatest hERG opening activity. In addition, functional studies on guinea pig isolated left atria, aorta, and ileum demonstrated that 8 does not present any cardiac or intestinal liability in our ex vivo studies. Due to its overall profile, (R,S)-8 paves the way for the design and development of a new series of compounds potentially useful in the treatment of both congenital and drug-induced forms of LQTS.Fondazione Telethon—Italy, Grant/Award Number: # GGP19134S