323,037 research outputs found
La condizione lavorativa degli stranieri tra integrazione e infortunistica professionale
No full textIl rischio di infortuni sul lavoro è generalmente più elevato per gli immigrati rispetto ai lavoratori autoctoni. Le ragioni riguardano principalmente l'assegnazione alle mansioni più pericolose, la natura spesso transitoria della loro situazione di sottoccupazione e di lavoro informale, le barriere linguistiche e culturali che riducono l'efficacia della prevenzione e molto altro che verrà qui analizzato mediante un aggiornato dettaglio
statistico
Life expectancy in the districts of Taranto
No full textThe "Taranto case" has aroused the scientific interest of demographers, statisticians, epidemiologists and doctors, to understand what is happening today to the health of citizens, finding excesses of mortality and morbidity in certain pathologies strictly connected to pollution, in particular in the Ionian capital and in some neighboring municipalities. We have developed abbreviated mortality tables, using a methodology essentially different from that of Istat due to the fact that we do not rework the probabilities of death at all, which remain real. This solution is valid as Taranto is a large municipality, with almost 200,000 inhabitants.Il “caso Taranto” ha suscitato l’interesse scientifico di demografi, statistici, epidemiologi e medici, per capire cosa accade oggi alla salute dei cittadini, riscontrandosi eccessi di mortalità e morbosità in determinate patologie strettamente connesse all’inquinamento, in particolare nel capoluogo jonico ed in alcuni comuni limitrofi. Abbiamo elaborato tavole di mortalità abbreviate, utilizzando una metodologia essenzialmente differente da quella Istat per il fatto che non rielaboriamo affatto le probabilità di decesso, che rimangono quelle reali. Tale soluzione risulta valida in quanto Taranto è un comune con quasi 200.000 abitanti
Drains, Germs, or Steel: Multidisciplinary Management of Acute Colonic Diverticulitis
No full textThe medical and surgical management of uncomplicated diverticulitis has changed over the last several years. Although immunocompetent patients or those without comorbidities can be treated with antibiotics as an outpatient, the efficacy of high-fiber intake or drugs such as mesalamine or rifaximin is not yet clearly established in the treatment of acute episodes and in the prevention of recurrences. On the other hand, the choice between antibiotic treatment and percutaneous drainage is not always obvious in diverticulitis complicated by abscess formation, especially for larger abscesses; although the results of studies comparing the two approaches remain controversial, surgery must be pursued for abscesses > 8 cm. For emergency surgery, the debate is still ongoing regarding laparoscopic lavage and surgical resection followed by primary anastomosis, since for both approaches the published reports are not in agreement regarding possible benefits. Therefore, these approaches are recommended only for selected patients under the care of experienced surgeons. Also, the contribution of elective surgery toward the overall approach has been revised; currently, it is reserved primarily for patients with a high risk of recurrence and whenever more conservative treatments were not effective
L'analisi quasi-real-time della mortalità tarantina fra emergenza ambientale e Covid-19
No full textIn un momento particolare per la realtà di
Taranto, stretta tra salute, ambiente e giustizia,
abbiamo voluto intervenire al Convegno per
evidenziare la validità di uno strumento, quale
l'osservatorio real-time di mortalità, che da alcuni
anni progettiamo come supporto sia alla medicina
che alla giustizia penale, in alternativa alle
classiche analisi/perizie epidemiologiche che
purtroppo si basano su informazioni datate.In a particular moment for the reality of Taranto,
squeezed between health, environment and
justice, we wanted to speak at the Conference to
highlight the validity of a tool, such as the realtime
mortality observatory, which we have been
planning for some years as a support for both
medicine and criminal justice, as an alternative to
the classic epidemiological analyzes/appraisals
which unfortunately are based on outdated
information
Proteogenomic biomarkers in colorectal cancers: clinical applications
No full textIntroduction: Colorectal cancer (CRC) is one of the leading cancers in terms of incidence and mortality, rate requiring a multidisciplinary approach. The discovery of specific CRC biomarkers has caused a paradigm shift in its clinical management. Areas covered: The aim is to illustrate the possible clinical applications of CRC biomarkers through an updated literature review (from 2015 to 2020) based on the PubMed database. A relationship between cancer localization and genetic profile has been identified. Nowadays, the tumor markers are largely used to select patients that could really benefit from a specific type of adjuvant therapy, in order to optimize treatment programs, especially in metastatic patients. This review highlights both CRC biomarkers’ advantages and critical issues. Expert opinion: New biomarker discoveries allow to set noninvasive tests that could increase patient’s compliance with therapy. They also permit a cost-effective early diagnosis, as well as patient-tailored treatments, improving the overall survival. The CRC biomarkers could also have a prognostic value, and usually, they are included in follow-up programs. However, despite the continuous progression of new technologies, their clinical validation is still debated. In this context, additional clinical studies are still necessary to identify, among potential markers, the most effective ones
Obstructing Left-Sided Colonic Cancer: Is Endoscopic Stenting a Bridge to Surgery or a Bridge to Nowhere?
No full textFor the 8–29% colorectal cancers that initially manifest with obstruction, emergency surgery (ES) was traditionally considered the only available therapy, despite high morbidity and mortality rates and the need for colostomy creation. More recently, malignant obstruction of the left colon can be temporized by endoscopic placement of a self-expanding metallic stent (SEMS), used as bridge to surgery (BTS), facilitating a laparoscopic approach and increasing the likelihood that a primary anastomosis instead of stoma would be used. Despite these attractive outcomes, the superiority of the BTS approach is not clearly established. Few authors have stressed the potential cancer risk associated with perforations that may occur during endoscopic stent placement, facilitating neoplastic spread and negatively impacting prognosis. For this reason, the current literature focuses on long-term oncologic outcomes such as disease-free survival, overall survival and recurrence rate that do seem not to differ between the ES and BTS approaches. This lack of consensus has spawned differing and sometimes discordant guidelines worldwide. In conclusion, 20 years after the first description of a colonic stent as BTS, the debate is still open, but the growing number of articles about the use of SEMS as a BTS signifies a great interest in the topic. We hope that these data will finally converge on a single set of recommendations supporting a management strategy with well-demonstrated superiority
Life expectancy in the districts of Taranto
No full textThe "Taranto case" has aroused the scientific interest of demographers, statisticians, epidemiologists and doctors, to understand what is happening today to the health of citizens, finding excesses of mortality and morbidity in certain pathologies strictly connected to pollution, in particular in the Ionian capital and in some neighboring municipalities. We have developed abbreviated mortality tables, using a methodology essentially different from that of Istat due to the fact that we do not rework the probabilities of death at all, which remain real. This solution is valid as Taranto is a large municipality, with almost 200,000 inhabitants
INTERNATIONAL VARIATION IN USE OF IMAGING FOR PATIENTS PRESENTING WITH RIGHT ILIAC FOSSA PAIN
No full textAim: To investigate variation in utilisation of diagnostic imaging for patients
presenting with right iliac fossa (RIF) pain across five countries.
Method: Prospective observational cohort study of adult (16 years and
above) patients presenting with RIF pain. The primary endpoint was the
overall imaging rate, including computed tomography (CT), magnetic
resonance (MRI), and ultrasound imaging. The secondary endpoint was the
negative appendicectomy rate (NAR; removal of a histologically normal
appendix).
Results: Data were collected in Ireland/UK (n1⁄47665; 169 centres), Italy
(n1⁄4782; 50 centres), and Spain/Portugal (n1⁄41046; 55 centres). Imaging
rates were lower in Ireland/UK (women: 74%, men: 41%) than in Italy
(women: 87%, men: 84%) and Spain/Portugal (89% for both women and
men). Overall CT and MRI scans rates were similar across all countries, but
ultrasound was more commonly used in Italy (77%) and Spain/Portugal
(81%) than Ireland/UK (46%). The overall NAR was higher in Ireland/UK
(16%) than in Italy (3%) and Spain/Portugal (6%).
Conclusions: Whilst rates of CT and MRI imaging were similar across the
five countries, the NAR was lowest in Italy and Spain/Portugal. It may be
possible to decrease the NAR in Ireland/UK without increasing the rate of
CT scanning
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