1,721,104 research outputs found
Postpartum readmissions and emergency department care following vaginal delivery in an Italian region
No full textThe objective of this study was to estimate hospital readmission and Emergency Department visit rates in puerperium among women discharged from the Italian Hospital of Udine after vaginal delivery. Administrative health databases of the Hospital were used as source of information. Readmissions or visits occurring within 42 days from deliveries recorded from 2000 to 2018 were analysed. Vaginal deliveries were 20756, postpartum readmissions 99 (0.48%) and ED visits 292 (1.41%). Readmissions occurred after a median time of 9 days from discharge, with median length of stay of 4 days. Postpartum ED visits occurred after a median of 15 days; 12.7% were yellow triage tags and 0.7% were red tags. Causes of readmissions and visits did not include only the specific complications of pregnancy, childbirth and puerperium; they differed in case of readmission or visit. Thus, readmissions only depict part of the postpartum hospital care needs of women after vaginal deliveries
Influenza molecular diagnostic testing in a 1000-bed academic Italian hospital during the 2018–19 influenza season
Full text linkAim: The aims of this study were to examine the requests for influenza molecular tests processed by the Virology Laboratory of the University Hospital of Udine during the 2018–19 influenza season and to assess the test results and to estimate costs. Subjects and methods: We analyzed various administrative databases of the hospital health information system, which can be deterministically linked at the individual level through an anonymous stochastic key. Requests for influenza molecular tests from November 1, 2018, to April 15, 2019, and test results were described by week and, for hospitalized patients, hospital ward. Previous vaccination status of tested patients, outcomes and estimated test costs were assessed. Results: In the 2018–19 influenza season, 979 influenza A and B virologic tests were processed by the laboratory, corresponding to 758 patients. Requests had more than doubled compared with the previous influenza season. Rapid real-time PCR tests, routinely available at the University Hospital of Udine since January 2019, represented 17% of requests. Six hundred forty-eight patients were hospitalized. Medical wards requested the test after a median of 1 day after admission, whereas requests were delayed for surgical and oncologic patients. The number of tests, proportion of positivity and consumption of rapid tests varied by medical specialty. Overall consumption of oseltamivir was similar to that of the previous influenza season. Conclusions: This analysis, benefiting from the availability of integrated health administrative databases, provided useful information to support public health decision-making and managing the supply and demand for diagnostic tests
RT-PCR tests for SARS-CoV-2 processed at a large Italian Hospital and false negative results among COVID-19 confirmed cases
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Healthcare and economic burden of ANCA-associated vasculitis in Italy: an integrated analysis from clinical and administrative databases
Full text linkANCA-associated vasculitides (AAV) comprise a group of systemic vasculitides characterized by inflammation of small-sized blood vessels leading to multi-organ involvement. The worldwide annual incidence of AAV ranges from 1.2 to 3.3 cases per 100 000 individuals with a prevalence of 4.6–42.1 cases per 100 000 individuals. The prevalence of AAV is geographically heterogeneous; therefore, regional epidemiological studies can be more informative to improve health care systems. Even though clinicians are aware that the healthcare burden and the risk of hospitalization of AAV appear high, data on hospitalization and cost of illness due to AAV are still scarce or even lacking. This study aims to characterize the economic burden of AAV in Friuli Venezia Giulia (FVG), Italy. Thus, a retrospective study was conducted through the integration of many administrative health databases of the FVG as the source of information. From data integration, we estimated that more than two-thirds of AAV patients showed at least one hospitalization in their medical history, most frequently caused by the disease itself or superimposed infections. Around 10% of patients developed end-stage renal disease. In an 8-year follow-up, the overall healthcare cost was € 1,215,078, corresponding to € 6,168 patient-year. ANCA-positive patients showed much higher costs than ANCA-negative patients did. Overall, AAV are rare diseases, but imply very high healthcare costs. Early diagnosis and optimal treatment probably still remain unmet needs for AAV
Videocapillaroscopic findings in the microcirculation of the psoriatic plaque during etanercept therapy
No full textBACKGROUND: Vascular endothelial growth factor (VEGF) is a pivotal cytokine in the pathogenesis of psoriasis, and upregulation of VEGF by tumour necrosis factor (TNF)-α and inflammatory factors causes marked alterations in the cutaneous microcirculation. Etanercept is a fully soluble TNF receptor fusion protein that primarily binds soluble TNF-α, thus blocking its pro-angiogenic function.
AIM: To assess the modifications in the superficial capillary bed in psoriatic plaques during treatment with etanercept.
METHODS: The study enrolled 22 patients (13 men, 9 women; age range 31-74 years) with plaque psoriasis resistant to conventional therapy. The patients were stated on etanercept 50 mg/week, which was continued for 24 weeks. At the beginning of the study (baseline), and at weeks 6, 12, 18 and 24, in vivo videocapillaroscopy analysis of a selected plaque was performed. Levels of erythema, scaling and infiltration were assessed using a four-point plaque severity score, with an overall score obtained by the sum of these three scores. The Psoriasis Activity and Severity Index (PASI) was also determined.
RESULTS: Etanercept produced a significant reduction in PASI, plaque severity score and diameter of the basket-weave area at every time point. Four patients had complete remission, although none of the patients regained a normal capillaroscopic pattern.
CONCLUSIONS: Similar to other conventional therapies, etanercept is able to improve PASI, plaque severity score and basket-weave area diameter, but it is unable to induce normalization of the microcirculation in psoriatic plaques
Pelvic floor muscle training after prostate surgery
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Urinary incontinence in men after formal one-to-one pelvic-floor muscle training following radical prostatectomy or transurethral resection of the prostate (MAPS): two parallel randomised controlled trial
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