Annali dell'Istituto Superiore di Sanità
Not a member yet
755 research outputs found
Sort by
A new treatment in the rehabilitation of the paretic upper limb after stroke: the ARAMIS prototype and treatment protocol
Get PDFBackground: In recent years, as part of the rehabilitation of post stroke patients had widespread use of robotic technologies to improve recovery of upper limb. ARAMIS is a concept robot and prototype designed to promote the arms functional interaction in the neurorehabilitation of the paretic upper limb. Two computer-controlled, symmetric and interacting exoskeletons compensate for the inadequate strength and accuracy of the paretic arm and the effect of gravity during rehabilitation. Rehabilitation is possible in 3 different modalities; asynchronous, synchronous, active-assisted.Objectives: to compare the effectiveness of rehabilitation robotic delivered through a exoskeleton prototype system compared to traditional rehabilitation in motor and functional recovery of the upper limb after stroke.Methods: case-control study, 52 patients enrolled in the study, 28 cases (female: 8, age: 65 ± 10 yrs.) treated with ARAMIS (Automatic Recovery Arm Motility Integrated System) and 24 controls (female: 11, age: 69 ± 7 yrs.) with conventional rehabilitation.Motor impairment assessed before and after treatment with Fugl-Meyer scale and Motricity Index, level of disability assessed with the Functional Independence Measure. A questionnaire also assessed the tolerability to therapy robotic.Results: After 28±4 sessions over a 54±3.6 days period, patients treated by ARAMIS improved at the Fugl-Meyer scale (global score from 43±18 to 73±29 [p<0.00001]), Motricity Index scale (p<0.004) and Functional Independence Measure (p<0.001). A lesser degree of improvement was achieved at the conventional rehabilitation, The Fugl-Meyer global score of the control group improved from 41±13 to 58±16 (P<0.006) and the motor function item from 9.4±4.1 to 14.9±5.8 (p<0.023).Conclusions: The motor improvement at wrist and hand proved greater than at shoulder and elbow in both patients treated by ARAMIS and controls, but it was significantly greater in ARAMIS-treated patients than in controls. The results indicate a greater efficacy of ARAMIS compared to conventional rehabilitation
The priority of Antonino D’Antona in describing rhabdomyolysis with acute kidney injury, following the Messina earthquake (December 28, 1908)
Get PDFFollowing the Messina-Reggio Calabria earthquake (December 28, 1908) outstanding medical reports were published by Franz von Colmers (1875-1960), Antonino D’Antona (1842-1913), and Rocco Caminiti (1868-1940). The reports of D’Antona and Caminiti were heretofore neglected. Colmers, D’Antona and Caminiti described crush-syndrome. D’Antona who cured patients in shock also described two deaths due to uraemia. This gives him a priority in the description of crush sy
Health status of the Italian people: gender inequalities
Get PDFDifferences between male and female affect diseases onset, evolution and prognosis. In terms of survival, women have a higher life expectancy at birth than men, with strong differences at regional level (the highest values in Trento AP and the lowest in Campania). Smoking, alcohol consumption, overweight and obesity and physical activities indicators are analyzed among men and woman. A reduction in smokers and number of smoked cigarettes is observed, especially among men. Men also show a higher number of exsmokers than woman. Also for alcohol consumption, the prevalence of consumers at risk is higher among men than women. Overweight and obesity are more prevalent among men than women, the same as physical activity played continuously and occasionally. Gender differences are also shown in hospitalization rate and mortality rate for ischemic heart disease, affecting men twice more than women. The analysis shows a good health status condition of Italian people, but it is important to be aware that gender is one of essential characteristics in health care field, independently of people age
The association between extreme weather conditions and work-related injuries and diseases. A systematic review of epidemiological studies
Get PDFIntroduction. The relationship between extreme temperature and population health has been well documented. Our objective was to assess the evidence supporting an association between extreme temperature and work related injuries. Methods. We carried out a systematic search with no date limits using PubMed, the Cochrane central register of controlled trials, EMBASE, Web of Science and the internet sites of key organizations on environmental and occupational health and safety. Risk of bias was evaluated with Cochrane procedure. Results. Among 270 studies selected at the first step, we analyzed 20 studies according to inclusion criteria (4 and 16 referring to extreme cold and heat temperature, respectively). Discussion. Despite the relevance for policy makers and for occupational safety authorities, the associations between extreme temperature and work related injuries is seldom analyzed. The estimation of risk, the identification of specific jobs involved and the characterization of the complex mechanisms involved could help to define prevention measures
A computational tool for evaluating HIFU safety
Get PDFBackground. High Intensity Focused Ultrasound (HIFU) is a noninvasive treatment for therapeutic applications, in particular the treatment of either benign or malignant tumor lesions. HIFU treatment is based on the power of a focused ultrasound beam to locally heat biological tissues over a necrotic level with minimal impact on the surrounding tissues. Therapies based on HIFU are becoming widely spread in the panorama of options offered by the Health Care System. Consequently, there is an ever increasing need to standardise quality assurance protocols and to develop computational tools to evaluate the output of clinical HIFU devices and ensuring safe delivery of HIFU treatment.Aims. Goal of this study is the development of a computational tool for HIFU ablation therapy to assure safety of the patient and effectiveness of the treatment. Results. The simulated results provide information about the behaviour of the focalized ultrasound in their interaction with different biological tissues.Conclusions. Numerical simulation represents a useful approach to predict the heath deposition and, consequently, to assess the safety and effectiveness of HIFU devices
Health facilities humanisation: design guidelines supported by statistical evidence
Get PDFBackground. Healthcare building humanisation is currently a widely debated issue and the development of patient centered and evidence based design is growing worldwide. Many international health organizations and researchers understand the importance of Patient Centred Design and leading architects incorporate it into the design process. In Italy this design approach is still at an early stage. The article refers to research commissioned by the Italian Health Ministry and carried out by R. Del Nord (Università degli Studi di Firenze) and G. Peretti (Politecnico di Torino) with their collaborators. The scope of the research was the definition of design guidelines for healthcare facilities humanisation. Method. The methodology framework adopted is the well established need and performance approach in architectural design. The article deals with the results of statistical Health facilities humanisation: design guidelines supported by statistical evidence Health facilities investigations for the definition and ranking of users’ needs and the consistent expression of their requirements. The investigations were carried out with the cooperation of psychologists of the Università degli Studi di Torino and researchers of the Università degli Studi di Cagliari. The proposed evaluation system allows ranking of health facilities according to the level of umanisation achieved. Results. The statistical investigation evidence collected allowed the definition of humanization design guidelines for health-care facilities and for the assessment of their specific level of humanisation.
Architectures for paediatric palliative care: how to improve quality of life and environmental well-being
Get PDFIntroduction. The influence of the environment on wellness, not only for patients themselves but for all care-givers as well, refers to the humanisation principles of spaces of care. Commencing with an analysis of existing paediatric hospices, the paper examines design suggestions for prosthetic environments, considered as a fundamental component in the healing process.Methodology. A prosthetic environment can be created only through a specific knowledge of the real needs of users. Therefore, some scholars have conducted research work for defining the best practices for healing environments, supported by an assessment and comparison of case studies. The methodology is based on two phases: the first is based on interviews with experts in hospice design and management and the second, through the application of a questionnaire to several users. Discussion and Results. The output of the work is the achievement of a logical, sequential and participatory broad-spectrum process in the design of health facilities in order to cause a sustainable awareness in paediatric hospices. Conclusion. Starting from the research work, it is necessary to define a scientific method for implementing knowledge on health, psychological, perceptual and behavioural needsto contribute towards proper planning for meeting the real requirements of users
Sex And Gender Equity in Research (SAGER): reporting guidelines as a framework of innovation for an equitable approach to gender medicine
Get PDFSex and gender are important determinants of health and influence research findings in variety of ways, yet they are often overlooked and underreported. This oversight limits he generalizability of research findings and their applicability to clinical practice. The bjective of this paper is to point out how journal editors can influence better reporting of sex and gender in research by establishing a methodological framework directly addressing vuthors of scientific publications, as well as referees, and indirectly affecting all the stakeholders in the research cycle, from funders to policy-makers and citizens. Such framework is represented by the Sex And Gender Equity in Research (SAGER) guidelines, developed by the European Association of Science Editors (EASE) to encourage a more systematic approach to the reporting of sex and gender in research across disciplines. The paper includes the rationale and basic principles of the SAGER guidelines.
Break with tradition: donating cadavers for scientific purposes and reducing the use of sentient beings
Get PDFIn recent years, the development of research and the increased awareness of our moral duties beyond the human species have pushed the scientific community to a revision of widely-accepted ontological reductionist views that regard non-human animals as mere things. Man, it seemed, did not have any kind of duty towards animals. The new horizons offered by the development of advanced research methods therefore require an ongoing commitment to new perspectives able to find the right balance between the need for scientific knowledge on one hand and the respect for animal life on the other. This is in line with increasing attention to animal welfare and expansion of the "3Rs model": Replacement, Reduction, Refinement.With the view of promoting the adoption of alternative methods, human body donation for research can contribute not only to the acquisition of important information for human health and for doctors\u27 training, but also can reduce significantly the number of animals sacrificed.By investigating the scientific and ethical reasons that may encourage cadaver donation, the authors aim to promote the adoption of the practice in Italy by also offering a practical guide to procedures in place in the principal European countries.