Pratica Medica & Aspetti Legali
Not a member yet
203 research outputs found
Sort by
Gestione del rischio clinico nell’ASL 3 Genovese: esperienze e prospettive
Full text linkIn recent years all the most authoritative healthcare organizations have underlined the importance of improving clinical risk management strategies to ensure patients safety and cost savings. This article describes a one-year experience in the contest of ASL 3 Genovese, showing the developement of a risk management project, its aims and its limits. An adequate risk management approach should be based on a “system approach”, which assumes that errors of individuals can’t be avoided, but the system that surrounds them should provide a safety net for these mistakes. Therefore, efforts are to create a cooperation based on trust, where it’s possible to learn from errors and thinking together about new solutions
L’importanza della farmacovigilanza in pediatria
Full text linkSafety data concerning drugs usage in children are often inadequate, because most of marketed medicines have not undergone clinical trials involving children: therefore many drugs used in children are used “off-label” or “off-licence” in paediatric population. Furthermore, Adverse Drug Reactions (ADRs) are a significant problem in paediatric patients, and can be different from those observed in adults, because of the different weight and the incomplete maturity of organs and systems. Clinical trials involving children have been started only few years ago, and their results will be available in a long time; clinical trials will identify the more common and predictable side effects of medicines, but the rarest ones will be seen only when the drug will be used in larger numbers of patients, under the conditions of every day use. For these reasons, paediatric pharmacovigilance is essential, providing data on ADRs and drugs safety from both spontaneous reports and active surveillance program, e.g. post-marketing safety studies, and ad hoc epidemiological studies
Ingegnerizzazione dei fattori umani e sicurezza dei pazienti
Full text linkHuman Factors Engineering (HFE) is a discipline concerned with the analysis, design, and development of human-technological systems in which the primary emphasis is to improve or optimize system performance by considering the human’s capabilities and limitations in the system. This article describes the applications of HFE to healthcare organization, to improve the performance of healthcare professionals and to reduce hazards
Il paziente poli-traumatizzato: aspetti medico-legali
Full text linkTrauma care is a higher medico-legal risk. In the United States, the American College of Surgeons developed The Advanced Trauma Life Support to teach doctors a safe, reliable method to assess and initially manage the trauma patient. This article examines the Italian situation, underlining the principles to provide an organized approach for evaluation and management of seriously injured patients and to offer a foundation of common knowledge for all members of the trauma team. Exploring the most important determinations of the Italian Law, the Author examines the risks of medical liability in civil and penal Code and describes the importance and the meaning of informed consent in trauma care
Il danno da emotrasfusione: dieci sentenze delle Sezioni Unite della Cassazione. II parte
Full text linkThe first part of this article, published in the 2008; 4(2) issue of this Journal, examined ten judgements of the United Sections of the Court of Cassation concerning negligent transfusion of infected blood, with transmission of hepatitis virus, B or C, or HIV. In this second part, the Author analyses some of these legal decisions with attention to prescription of the judgement, worsening of the infected patient, value of Commissions proceedings, and causal connection
I disturbi del comportamento alimentare (DCA): riflessioni e problematiche
Full text linkEating disorders (ED) are an important cause of physical and psychosocial morbidity in adolescents and young adults, characterized by aberrant patterns of eating behavior and weight regulation and by disturbances in attitudes towards weight and perception of body shape. This article, through the description of a clinical case, focuses on the complexities of clinical management and on the importance of an integrated approach
Consenso informato e tutela della riservatezza nell’accertamento dell’infezione da HIV
Full text linkA recent judgement of the Court of Cassation gives important instructions about informed consent and right of the protection of personal data in the health care sector in case of HIV-related infection, on the ground of Section 5 of Act n. 135 of June 1990: HIV test is voluntary and health care professionals shall be required to take all the measures and precautions to protect the subject’s right and fundamental freedoms and dignity
Cardiotossicità da agenti antitumorali
Full text linkChemotherapy-induced cardiotoxicity remains an unresolved problem strongly impacting the quality of life and the overall survival of cancer patients. The most typical form of cardiotoxicity, a dilated cardiomyopathy, usually becomes manifest late in the course of the disease and it is classically considered to be refractory to therapy. Detection of subclinical cardiac injury is crucial since it may facilitate early therapeutic measures. To detect cardiac damage, the most frequently adopted diagnostic approach is the monitoring of left ventricular ejection fraction by echocardiography or radionuclide-angiocardiography; however, these methods utilized in clinical practice have low sensitivity and poor predictive value. Hence, other strategies, including an early detection of cardiotoxicity by biomarkers, have been proposed. The role of troponin I in identifying patients at risk of cardiotoxicity, and of angiotensin-converting enzyme inhibitors in preventing left ventricular ejection fraction reduction and cardiac events, is clearly emerging as an effective approach for the prevention of this complications. When chemotherapy-induced cardiomyopathy develops, however, no definite guidelines are currently adopted, and, although it is likely that angiotensin-converting enzyme inhibitors and beta-blockers may be highly effective, there is still some unjustified concern about using them in cancer patients
Dal packaging all’errore: casi esemplari e aspetti normativi
Full text linkA number of factors can contribute to medication errors, and packaging may be one cause. For example a medication can be mistakenly administered either because the drug container (eg, iv bag, prefilled syringe, etc.) is similar in appearance to the intended medication’s container or because the packages had similar labelling. The Authors describe three case reports that show how an unclear packaging can be responsible for inappropriate use, and subsequent patient’s injuries. Hospital pharmacy staff, prescribing physicians, other healthcare workers, and even patients can play a role in minimizing the occurrence of these types of errors. However also drug manufacturers have an important role and should provide clear and unique labels and packages for their products, as underlined by pharmaceutical packaging legislation and regulations
Le interazioni tra farmacie le possibili sospette reazioni avverse gravi: l’uso della pillola anticoncezionale
Full text linkInteractions between herbal remedies or food and conventional therapies represent a risk often underestimated by physicians. Besides, wide spreading of over the counter medications and the practise of self medication may enhance the risk, also because a high proportion consumers of herbal remedies could not consult their general practitioner or pharmacist following adverse drug reactions to such remedies. The aim of the article is to provide information and news about the risk of interactions between drugs, and to prevent adverse events related to drugs, promoting monitoring for symptoms and improving communication between patients and providers