1,584 research outputs found
The burden of hepatic encephalopathy and the use of albumin as a potential treatment
No full textAs a potential sequela of cirrhosis, hepatic encephalopathy (HE) significantly impacts the lives of patients and caregivers and places a substantial burden on the healthcare system. With an increasing incidence over time and a cumulative effect on cognition, HE adversely effects quality of life, morbidity and mortality in patients with cirrhosis. HE can range from minimal or covert (MHE/CHE) to overt and symptomatic (OHE). HE has profound impacts on the health and wellbeing of patients and their families and caregivers. Effective treatments could improve the quality of life for all those affected. In this article, we discuss the existing treatments for HE and focus on the potential role of albumin in the treatment of HE. Currently approved therapies for HE (lactulose and rifaximin) are focused on decreasing the formation of ammonia in the gastrointestinal tract. Among the many agents with alternative mechanisms being investigated for treatment of HE, albumin has been studied in clinical trials with acute (≤ 3 days), short-term (up to 2 weeks) prolonged (> 2 weeks) and long-term administration (months). Current studies indicate that acute or short-term administration of albumin does not provide significant benefit for patients with OHE. However, there is increasing evidence that prolonged or long-term albumin therapy can help improve cognition in OHE and prevent recurrence. Additional studies are needed to substantiate these positive findings for longer term administration of albumin in HE and to increase our comprehension of the pharmacologic basis of the effects of albumin
Albumin in hospitalized patients with complications of cirrhosis: Not a suit for all seasons
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Manuale di psichiatria territoriale
No full textQuesto manuale nasce nel territorio ed è pensato per il territorio. La necessità di garantire agli utenti dei Servizi di Salute Mentale i migliori trattamenti possibili in termini di appropriatezza e di rigore metodologico è il denominatore comune dell’opera.
Alla stesura dei capitoli hanno partecipato, con contributi originali ed esaustivi, prestigiosi specialisti nella psichiatria di comunità italiani e stranieri.
Si parte dalla definizione di territorio e si individuano, in un percorso ideale, le varie tappe per costruire un’assistenza e un’organizzazione dei servizi centrati sulla persona.
Lo spirito dell’opera è quello di inserire il singolo intervento tecnico all’interno di una cornice teorica articolata, che preveda la possibilità di elaborare, per un singolo paziente, il trattamento ideale
Suicide prevention: A long-lasting Italian tradition. Toward understanding the suicidal mind
No full textObjective: Suicide is a serious public health problem. The World Health Organization (WHO), recognizing the growing problem of suicide worldwide, and urged member nations to address the phenomenon. Methods: Since Enrico Morselli's report, suicide rates have changed dramatically in some Italian areas, whereas the rates have remained approximately the same in other regions (Figs. 1, 2). Italy has a long-lasting tradition in the study of suicide and nowadays it is crucial to learn more about assessment and management of suicide risk. Suicidal individuals often talk about suicide, death, and/or having no reason to live. Results: Most suicidal individuals give definite warnings of their suicidal intentions, but significant others are either unaware of the significance of these warnings or do not know how to respond to them. The assumption that these individuals want to die because they suffer from a psychiatric disorder must be substituted by a phenomenological approach of suicide. An approach centred on intersubjectivity recognizes the unbearable psychological pain for which the suicide is perceived as the best solution. Suicide is best understood not so much as a movement toward death as it is a movement away from something and that something is always the same: intolerable emotion, unendurable, or unacceptable anguish. If the level of suffering is reduced the individual will choose to live. Conclusions: The author discusses the drama occuring in the mind a comparison of suicide rates at the time of Morselli with the present ones and overviews the drama occurring in the mind of suicidal individuals and how to help them
Suicide on my mind. A look back and ahead at suicide prevention in Italy
No full textSuicide is a serious public health problem. The World Health Organization (WHO), recognizing the growing problem of suicide worldwide and urged member nations to address the phenomenon. Since the time of Enrico Morselli, the suicide rate the changed dramatically in some Italian areas whereas it has remained approximately the same in other regions. During the period 1980-2006, about 4000 suicide deaths among Italian residents were certified on average each year. For each suicide there are probably about twenty suicide attempts resulting in a great burden for individuals, their families and society. Suicidal individuals often talk about suicide, death, and/or having no reason to live. Most suicidal individuals give definite warnings of their suicidal intentions, but significant others are either unaware of the significance of these warnings or do not know how to respond to them. The assumption that these individuals want to die because they suffer from a psychiatric disorder must be substituted by a phenomenological approach to suicide. An approach centred on the intersubjectivity allows recognition an unbearable psychological pain for which the suicide is perceived as the best solution. Suicide is best understood not so much as a movement toward death as it is a movement away from something and that something is always the same: intolerable emotion, unendurable, or unacceptable anguish. If the level of suffering is reduced the individual will choose to live. The author looks back and ahead for preventing suicide in the Italian territory and reflects on the many suicide activities across Italy in which he was involved over the past two years
Alcol e salute
No full textSecondo gli storici, il brindisi probabilmente ebbe origine dalle libagioni greche, in cui una parte della bevanda veniva versata in terra o su un altare in onore degli dei. La scoperta della distillazione diede avvio ad una serie di applicazioni “innovative” per l’alcol: lo sviluppo di farmaci ottenuti dall’estrazione su base alcolica di piante officinali da un lato e dall’altro la diffusione sul mercato di superalcolici per uso voluttuario dotati però di una maggiore efficaci psicotropa. Nel corso del 1900 i danni legati all’alcol sono stati descritti sempre con maggiore sistematicità, dopo aver trovato danni legati all’uso cronico di alcolici a carico del cuore e del fegato sono stati scoperti quelli a carico del sistema nervoso centrale
David Audretsch: A Source of Inspiration, a Co-author, and a Friend
No full textIn this chapter, Enrico Santarelli discusses the profound impact that David had on his career. Beginning with a conference in Budapest, Santarelli and David bocame close friends and colleagues. They went on to collaborate on many papers and projects, several of which Santarelli highlights below
TV medical drama: how to talk about public health in Italian primetime
No full textBackground and Objective: Television is one of the most effective media for conveying important public health messages and promoting prosocial behaviors. In addition, television medical dramas often depict the practice of medicine and thus can influence the knowledge and behavior of a large audience. Our aim was to analyze how public health issues are addressed in the most popular medical dramas.
Methods: We selected the two most popular television medical dramas in Italy that aired in prime time between 2012 and 2019 and are also available on DVD or paid platforms. A total of 94 episodes of Greys Anatomy and House, M.D. (49 and 45, respectively) were analyzed in double blind. Each episode was assessed using a
checklist that described the health promotion topics covered and the compliance with infection risk prevention for each procedure performed.
Results: At least one public health topic was addressed in 57 (61%) episodes (86 total cases), including: blood and organ donation (33%), drug and alcohol abuse (27% and 17%, respectively), healthy eating (9%), physical activity (9%), sexually transmitted diseases (6%), immunizations (3%), screening programs (3%) and smoking (1%). No reference was made to sleep education and promotion of sleep hygiene. Proper hand hygiene was depicted in 10% of the potential 239 procedures. The use of disposable gloves and gowns (PPE=personal protective equipment) was appropriate in 92% and 74%, respectively, of the 191 procedures in which their use was required by the guidelines.
Conclusion: In the episodes analyzed, healthy lifestyles (i.e., smoking abstinence) or vaccination were addressed only superficially, and the use of PPE was also partially presented before the pandemic. Given their large audience size, medical dramas should better used to communicate important public health issues to the general public
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