Pratica Medica & Aspetti Legali
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La fecondazione assistita come malattia indennizzabile: analisi delle tecniche e profili medico-legali di indennizzabilità INPS
No full text[Medically assisted procreation and work indemnity: techniques and INPS medical and legal profiles]Infertility is defined as a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse. Assisted reproductive technology (ART) consists of all treatments or procedures that include the in vitro handling of both human oocytes and sperm or of embryos for the purpose of establishing a pregnancy (including, for example, in vitro fertilization, gamete and embryo cryopreservation, etc.). In Italy medically assisted procreation (MAP) is regulated by the Law 40/2004, which places strict limits on the use of ART. This article examines access to MAP techniques and their efficacy rates. It also describes the Italian National Social Security Institute (INPS) regulations on work indemnity in case of MAP
Le malattie croniche quale causa di temporanea incapacità lavorativa
No full text[Chronic disease as a cause for temporary inability to work]A chronic disease is defined as a «disease of long duration and generally slow progression». According to policies about work leave developed by INPS, the Italian National Social Security Institute, only the acute phases of chronic diseases can be considered a compensable disease: in these cases a paid sickness absence is due to the employee. Chronic manifestations, on the contrary, are not compensable. In these cases, the employee is protected by other instruments, such as invalidity. This article examines some cases of chronic diseases, explaining the regulations provided by INPS
La malattia insorta durante il periodo di ferie
No full text[Illness arising during holidays]This article examines the Italian situation about the illness arising during the holidays. The Italian Constitution states that workers have the right to a weekly rest day and paid annual holidays. The holidays are intended to rest and recover psychophysical energies. Therefeore if during this period comes a state of illness that prevents this recovery, the employee may terminate the leave. According to the Italian regulations, holidays aren’t automatically stopped, but it’s required that the state of illness prevents the worker actually to enjoy the rest and the recovery of psychophysical energies. For example, headache, having marginal reflections on the enjoyment of the holiday, is not likely to stop it. This is regulated by INPS, that should receive immediate notification of the disease
Applicazione di un sistema di mappatura dei rischi nella Diagnostica per Immagini
No full text[Applying a system of risk mapping in Diagnostic Imaging]Six hospitals in Emilia-Romagna have developed a system of detection and classification of adverse events in Diagnostic Imaging, according to a mapping of hazards, in order to assess and ensure greater patient’s safety. A seventeen-month trial was carried out using this system and involving 19 operational units in several Diagnostic Imaging-related branches (Diagnostic and Interventional Radiology, Nuclear Medicine, Neuroradiology, Ultrasound). The project is a multi-center spin-off of the broader program of the Agenzia Sanitaria e Sociale Regionale – Regione Emilia-Romagna (ASSR-RER) of clinical risk management in healthcare organizations. This experience has demonstrated the importance of the classification of adverse events and near misses in radiology and the preparation of a specific incident reporting form that will facilitate the voluntary reporting of events by medical personnel. The data analysis has provided reassuring data concerning the overall safety of the Radiology Departments examined
La malattia indennizzabile
No full text[Compensable illness]Abstract non disponibile. Si riportano di seguito le parti iniziali dell\u27articolo:L\u27assicurazione contro le malattie gestita dall’INPS ruota intorno al concetto di "malattia indennizzabile", la cui nozione non è definita da una singola norma di riferimento, ma deve essere dedotta dall’insieme delle disposizioni che disciplinano i fondamenti giuridici dell’istituto, le modalità di denuncia dell’evento e dell’accertamento medico legale del rischio
Chirurgia estetica e malattia non indennizzabile: aspetti medico-legali
No full text[Plastic surgery and work indemnity: medical and legal aspects]Plastic surgery procedures are growing in recent years. Given the often intrusive and complicated nature of such operations, patients who underwent these operations are often unable to return to work and will have a period of sickness absence. This article examines the cases in which employees can take a job-protected leave after surgical operations. The general rule, established by INPS, is that these surgical procedures can be paid only if there had a therapeutic aim. In all the other cases, which are more common, no legitimate job-protected leave can be taken by the employee. Conditions for which plastic surgery is usually administered are not "serious health conditions" unless inpatient hospital care is required or unless complications develop. In particular, the author examines the most popular interventions, such as mammoplasty (breast augmentation, breast reduction, and mastopexy), rhinoplasty, and abdominoplasty, specifying, for each procedure, when it can be considered as a therapeutic procedure and when it can’t
Il giudizio prognostico nell’evento malattia
No full textoai:journals.seedmedicalpublishers.com:article/290[The prognostic judgment in the disease]Abstract non presente. Si riporta l\u27inizio dell\u27editoriale:La certificazione di malattia per fini lavorativi viene redatta dal medico di medicina generale (MMG) stabilendo non la prognosi clinica della malattia e il tempo necessario al paziente per la restitutio ad integrum, bensì la sua rilevanza rispetto all’idoneità al lavoro specifico svolto.L’art. 24 del codice deontologico precisa che il medico curante è tenuto ad attestare i dati clinici direttamente constatati e/o oggettivamente confermati, comportandosi con la massima diligenza, registrando i dati attentamente e correttamente e formulando giudizi obiettivi e scientificamente corretti.La certificazione di malattia ai fini lavorativi, ha, in effetti, una sua ricaduta precisa sui diritti del lavoratore e sulle prestazioni economiche erogate dagli enti previdenziali: in effetti, se dalla malattia, secondo quanto dichiarato dal MMG, scaturisce un’infermità comportante incapacità lavorativa e la totale impossibilità temporanea della prestazione, l’art. 2 del D.L. 663/1979 sancisce il diritto per il lavoratore di beneficiare dei mezzi di sostentamento adeguati alle sue esigenze di vita
Le visite mediche di controllo: presupposti normativi e modelli organizzativi
No full text[Control visits: regulations and organizative methods]This article describes the Italian regulations about the illness certificate and control visits. Physician’s obligations are listed, together with roles and functions of Italian National Institute for Social Insurance (INPS). Worker’s and employer’s obligations are also examined. Recently, INPS developed a data transmission system in order to allow the physician an easy and fast completion of a certificate for the patient. The system also allow the worker and the employer to access the certificate of illness, thus increasing the quickness of the procedure. This article describes the procedure for the electronic transmission of the certification, highlighting the new and forthcoming telematic procedures
Rilevanza clinica e aspetti medico-legali delle interazioni tra farmaci
No full text[Clinical relevance and medical legal aspects of drug-drug interactions]Drug-drug interactions (DDIs) are an important issue of clinical pharmacology. A drug interaction occurs when the amount or the action of a drug is altered by the administration of another drug or multiple drugs. The result of a DDI can be the onset of an adverse drug reaction (ADR), the lack or the reduction of efficacy or the increase of a pharmacological effect. Apart from pharmaceutical interactions, DDIs are generally classified as pharmacokinetic or pharmacodynamic, according to the underlying mechanism. The majority of known DDIs involve the drug metabolism. The main risk factors for DDIs are age, polypharmacy, self-medication, concomitant diseases, narrow therapeutic range and dosage. In the literature most of the studies on DDIs focused on potential interactions and most data about the epidemiology of actual DDIs are related to the out-inpatient settings with different incidences. In general the incidence of actual DDIs is lower than that of potential ones, however DDIs represent a significant proportion of ADRs, since the absolute number of patients involved is high. The use of specific suggestions and recommendations could be effective in the reduction of ADRs from DDIs
Valutazione dei rischi connessi all’utilizzo di prodotti farmaceutici e parafarmaceutici contenenti piante medicinali
No full text[Evaluation of risks related to the use of pharmaceutical and parapharmaceutical herbal products]The increasing interest in natural and complementary products for the treatment of many different diseases leads to important concern about their safety. Phytotherapy and dietary supplementation with herbal products can be useful in clinical practice, but health care professionals should carefully consider a comprehensive clinical risk assessment. Recognition of adverse events related to the use of medicinal herbs should involve a complete analysis of their main characteristics, together with the assessment of patients’ clinical conditions, concomitant drug intake and history of use. This process is important, not only because it may prevent adverse events, but also to improve pharmacovigilance reports