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Altini M, Solinas L, Bucchi L, Gentili N, Gallegati D, Balzi W, Falcini F, Massa I. Assessment of Cancer Care Costs in Disease-Specific Cancer Care Pathways. Int J Environ Res Public Health 2020; 17:ijerph17134765. [PMID: 32630745 PMCID: PMC7369964 DOI: 10.3390/ijerph17134765] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 06/29/2020] [Accepted: 06/30/2020] [Indexed: 01/04/2023]
Abstract
In view of an efficient use of the Italian National Health Service-funded healthcare resources, a novel data-processing strategy combining information from multiple sources was developed in a regional cancer network of northern Italy. The goal was to calculate the annual overall cost of care pathways of six disease groups in 10,486 patients. The evaluation was conceived as a population-based cost description from the perspective of the Italian National Health Service. Costs occurred during a defined time period for a cross-section of patients at varying stages of their disease were measured. The total cancer care cost was €81,170,121 (11.1% of total local health expenditure), with a cost per patient of €7741.17 and a cost per capita of €204.62. Surgical, inpatient and day-hospital medical admissions, radiotherapy, drugs, outpatient care, emergency admissions, and home and hospice care accounted for 21.2%, 24.1%, 6.2%, 28.2%, 14.0%, 0.9%, and 5.4% of the total cost, respectively. The highest cost items included drugs (cost per capita, €22.95; 11.2% of total cost) and medical admissions (€14.51; 7.1%) for blood cancer, and surgical (€14.56; 7.1%) and medical admissions (€13.60; 6.6%) for gastrointestinal cancer. The information extracted allows multidisciplinary cancer care teams to be more aware of the costs of their clinical decisions.
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Affiliation(s)
- Mattia Altini
- Healthcare Administration, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (M.A.); (W.B.)
| | - Laura Solinas
- Management and Accounting Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (L.S.); (D.G.)
| | - Lauro Bucchi
- Romagna Cancer Registry, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy;
- Correspondence: ; Tel.: +39-0543-739-455; Fax: +39-0543-739-459
| | - Nicola Gentili
- Information Technology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy;
| | - Davide Gallegati
- Management and Accounting Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (L.S.); (D.G.)
| | - William Balzi
- Healthcare Administration, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (M.A.); (W.B.)
| | - Fabio Falcini
- Romagna Cancer Registry, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy;
- Cancer Prevention Unit, Morgagni-Pierantoni Hospital, 47121 Forlì, Italy
| | - Ilaria Massa
- Unit of Biostatistic and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy;
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Mancini S, Solinas L, Leone L, Battaglia B, Notarangelo MG, Hassan R, Di Cosimo C, Angeloni R, Belardi A, Cosentino L, Bakacs A, Sagnotta A. Jejunal metastasis of Merkel cell carcinoma: case report. G Chir 2019; 40:364-367. [PMID: 32011994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Merkel cell carcinoma (MCC) of the skin is a rare but aggressive cutaneous neuroendocrine-derived malignancy that predominantly affects elderly white males. The presence of distant nodal metastases significantly impacts survival. Typical metastatic sites of MCC are liver, bone, brain and skin. Gastrointestinal metastases are uncommon and small bowel is the most common site followed by stomach. We report a case of symptomatic MCC jejunal metastasis.
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Matteucci F, Solinas L, Turri V, Donati C, D'errico V, Moretti A, Bianchini D, Paganelli G, Gallegati D, Altini M. IntegoTM infusion system: cost effectiveness analysis focusing on dosimetry, sterility and management. Q J Nucl Med Mol Imaging 2019; 63:183-190. [PMID: 27387379 DOI: 10.23736/s1824-4785.16.02866-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Healthcare providers across Europe are facing an ever-growing demand in clinical PET referrals. Currently, it is estimated that the administration of the PET tracer accounts for approximately 40% of the unitary PET procedure reimbursement (uPETr). Although the cost of PET/CT is highly dependent on the radiopharmaceutical cost itself, little is known about the economic impact of the utilized administration method and the repercussions on staff radiation exposure. Our objective was to evaluate the cost-effectiveness of automatic injection/fractionation system Intego™ (Bayer HealthCare, MEDRAD Europe, Netherlands) for istaff radiation exposure reduction and to validate its use with 18F-choline (FCH). METHODS In order to validate Intego™ use with FCH we analyzed sterility, radioactivity fractionation accuracy and radiation protection for staff. We analyzed Intego™ impact on examination costs and its impact on organization efficiency. A cost-effectiveness analysis (CEA) was estimated as the incremental cost to reduce staff radiationexposure. RESULTS According to our data, Intego™ ensures both sterility and accuracy of FCH doses' activity, reducing, at the same time, the exposure to radiation either whole body and at the extremities (94% and 75% respectively for the technicians and complete reduction for physicians). Intego™'s variable unit costs are higher than the SA (respectively 1.8% and 0.4% of PET reimbursement), while staff costs are significantly higher with SA (respectively 0.27% and 1.57% of unitary PET reimbursement [uPETr]). In our simulation, based on a 2,450 PET yearly output, the differential costs were slightly higher by using Intego™™ (+ 14%). The incremental cost-effectiveness ratio (ICER) was equal to 1.1, i.e. the healthcare provider pays an additional cost of 0.38% of uPETr to obtain a significant reduction of staff radiation exposure (-4.5 µS). CONCLUSIONS Intego™, for its favorable results in terms of cost effectiveness, could be a useful tool in a nuclear medicine department, limiting the staff radiation exposure.
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Affiliation(s)
- Federica Matteucci
- Nuclear Medicine Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), Forlì-Cesena, Italy -
| | - Laura Solinas
- Planning and Control Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), Forlì-Cesena, Italy
| | - Valentina Turri
- Health Care Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), Forlì-Cesena, Italy
| | - Caterina Donati
- Pharmacy Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), Forlì-Cesena, Italy
| | - Vincenzo D'errico
- Medical Physics Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), Forlì-Cesena, Italy
| | - Andrea Moretti
- Nuclear Medicine Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), Forlì-Cesena, Italy
| | - David Bianchini
- Medical Physics Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), Forlì-Cesena, Italy
| | - Giovanni Paganelli
- Nuclear Medicine Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), Forlì-Cesena, Italy
| | - Davide Gallegati
- Planning and Control Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), Forlì-Cesena, Italy
| | - Mattia Altini
- Health Care Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), Forlì-Cesena, Italy
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Hassan R, Solinas L, Notarangelo M, Sagnotta A, Giubilo C, Battaglia B, Di Cosimo C, Mancini S. Mirizzi syndrome: a challenging diagnosis. Case report. G Chir 2019; 40:193-198. [PMID: 31484008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Mirizzi Syndrome (MS) is an uncommon complication of chronic gallstone disease defined as a common bile duct (CBD) obstruction secondary to gallstone impaction in the cystic duct or gallbladder neck. MS is still a challenging clinical situation: preoperative diagnosis of MS is complex and can be made in 18-62.5% of patients. Over 50% of patients with MS is diagnosed during surgery. In most of cases, laparotomy is the preferred surgical approach. We report the case of a 70-year-old woman with a history of asthenia, jaundice, abdominal pain and preoperative imaging that suggest the presence of biliary stones with a choledocal stenosis. Intraoperatively, a MS with cholecysto-biliary fistula involving less than two-thirds of the circumference of the bile duct was diagnosed and successfully treated.
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Solinas L, Sagnotta A, Chessa A, Fiorini A, Battaglia B, Di Cosimo C, Notarangelo MG, Hassan R, Leone L, Mancini S. Pseudomixoma peritonei associated with appendiceal cistoadenoma rupture: case report. G Chir 2019; 40:213-216. [PMID: 31484011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Appendiceal mucocele represents specimen finding in 0.2-0.3% out of appendectomies. The rupture or perforation in peritoneal cavity might cause pseudomixoma peritonei (PMP), with multiple mucinous deposits in the abdominal cavity. We report a case of PMP caused by a perforated appendiceal cistoadeonoma.
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Altini M, Gallegati D, Solinas L, Gentili N, Massa I, Amadori D. Economic burden of cancer: a population-based cost analysis. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx436.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Serra P, Mercatali L, Masalu N, Bongiovanni A, Pangan A, Tedaldi R, Scarpi E, Nanni O, La Manna F, Spadazzi C, Ibrahim T, Rocca A, Solinas L, Amadori D. Is Vit D serum concentration related to Italian and Tanzanian breast cancer cases? J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.e22248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Laura Mercatali
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) s.r.l., IRCCS - Osteoncology and Rare Tumors Center, Meldola, Italy
| | | | - Alberto Bongiovanni
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) s.r.l., IRCCS - Osteoncology and Rare Tumors Center, Meldola, Italy
| | | | | | - Emanuela Scarpi
- Unit of Biostatistics and Clinical Trials, IRST, IRCCS, Meldola, Italy
| | - Oriana Nanni
- IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), Meldola, Italy
| | - Federico La Manna
- Istituto Scientifico per lo Studio e la Cura dei Tumori (IRST) s.r.l. IRCCS, Osteoncology and Rare Tumors Center, Meldola, Italy
| | - Chiara Spadazzi
- Osteoncology and Rare Tumors Center IRCCS IRST, Meldola, Italy
| | - Toni Ibrahim
- Istituto Scientifico Romagnolo per Lo Studio e La Cura Dei Tumori, Meldola, Italy
| | - Andrea Rocca
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | | | - Dino Amadori
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
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Dente M, Cilurso F, Fornari L, Morano C, Moretti M, Neri T, Solinas L, Tiberi R, Anastasio G, Santi F, Bagarani M. [Intestinal perforation due to accidental ingestion of foreign bodies]. G Chir 2010; 31:38-41. [PMID: 20298665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Usually the ingested foreign bodies (IFB) pass the gastrointestinal tract making no lesions. Sometimes IFB could lead to a gastrointestinal perforation. The most frequently perforating IFB are chicken or fish bones and toothpicks, while risks factors are mental retardation, alcohol or drug abuse, denture usage, quick eating or habitual chewing of toothpicks. The accidentally ingestion in a high risk patient with unclear symptoms, added to a low sensitive diagnostic imaging, lead to intraoperative diagnosis in one half cases of gastrointestinal perforation by IFB. Furthermore the surgical treatment range between the less minimal invasive laparoscopic IFB extraction and intraabdominal hole suture to a laparotomic bowel or colic resection. Herein we describe our experience in 3 cases of gastrointestinal perforation by IFB have been diagnosed at surgery and treated by IFB extraction and hole suture (in 2 patients; 1 laparoscopy, 1 laparotomy) or open right emicolectomy (1 patient).
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Affiliation(s)
- M Dente
- Dipartimento di Chirurgia Digestiva ed Endocrina, Ospedale Regina Apostolorum, Albano, Roma
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Dulucq JL, Wintringer P, Stabilini C, Solinas L, Perissat J, Mahajna A. Laparoscopic and open gastric resections for malignant lesions: a prospective comparative study. Surg Endosc 2005; 19:933-8. [PMID: 15920691 DOI: 10.1007/s00464-004-2172-9] [Citation(s) in RCA: 82] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2004] [Accepted: 01/17/2005] [Indexed: 12/13/2022]
Abstract
BACKGROUND Whereas laparoscopy for benign diseases provides clear advantages over traditional surgery, the benefits of laparoscopic gastric resection for malignant diseases are less clear. The objectives of this study were to compare prospectively the clinical outcomes between completely laparoscopic and open total and partial gastrectomies for malignant diseases and to assess whether laparoscopic gastrectomies obtain adequate margins and follow oncologic principles. METHODS Between April 1995 and March 2004, a prospective comparative study was performed comparing eight patients who underwent laparoscopic total gastrectomy with 11 patients who underwent open total gastrectomy, and 16 patients who underwent laparoscopic partial gastrectomy with 17 who patients underwent open partial gastrectomy. Stage, extent of lymphadenectomy, and long-term follow-up were examined. The intraoperative and postoperative details of the two groups were compared. RESULTS The laparoscopic group patients had fewer intraoperative complications while the operative time was similar to that of the open group. Both ambulation and hospital stay were significantly shorter in the laparoscopic groups than in the open groups. The short-term morbidity was lower in the laparoscopic groups and there were no cases of death, whereas one case of postoperative death occurred after an open total gastrectomy. There was no need to convert to open surgery. The number of lymph nodes obtained in the laparoscopic and open procedures was not significantly different. In addition, all resected margins were tumor free in the laparoscopic group, whereas tumor involvement was presented in the margin of one specimen in the open group. CONCLUSIONS The totally laparoscopic approach to total and partial gastrectomies had good results and was proven to be a feasible and safe procedure. In addition, the laparoscopic procedures are superior to open surgeries in terms of faster postoperative recovery, shorter hospital stay, and better cosmetic outcomes. A totally laparoscopic approach for early and advanced gastric cancer can obtain adequate margins and follow oncologic principles.
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Affiliation(s)
- J-L Dulucq
- Department of Abdominal Surgery, Maison de Santé Protestante, Bagatelle, Route de Toulouse 203, 33401, Talence-Bordeaux, France.
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Cassin M, Badano LP, Solinas L, Macor F, Burelli C, Antonini-Canterin F, Cappelletti P, Rubin D, Tropeano P, Deganuto L, Nicolosi GL. [Is a more efficient operative strategy feasible for the emergency management of the patient with acute chest pain?]. Ital Heart J Suppl 2000; 1:186-201. [PMID: 10731376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
Patients with acute chest pain are a common problem and a difficult challenge for clinicians. In the United States more than 5 million patients are examined in the emergency department on a yearly basis, at a cost of 6 billion dollars. In the CHEPER registry the prevalence of patients with chest pain in the Emergency Department was 5.3%. Similarly, in 1997 at our institution the prevalence was 4.8%. Only 50% of the patients are subsequently found to have cardiac ischemia as the cause of their symptoms and 50-60% of them showed a non-diagnostic electrocardiogram (ECG). Twenty-five-50% of chest pain patients are not appropriately admitted to the hospital and despite this conservative approach, acute myocardial infarction is misdiagnosed up to 8% of patients with acute chest pain who are released from the emergency department without further evaluation, accounting for approximately 20% of emergency department malpractice in the United States. Important diagnostic information is covered by the patient's medical history, physical examination, and ECG, but often this approach is inadequate for a definitive diagnosis. Creatine kinase (CK) and CK isoenzyme--cardiac muscle subunit (CK-MB)--are traditionally obtained in the emergency department in patients admitted for suspected acute coronary syndrome. Mass measurements of CK-MB have improved sensitivity and specificity, and to date this is the gold standard test for diagnosis of acute myocardial infarction. CK-MB, however, is not a perfect marker because it is not totally cardiac specific and does not identify patients with unstable angina and minimal myocardial damage. There are no controlled clinical impact trials showing that these tests are effective in deciding whether to discharge or to appropriately admit the patient with suspected acute coronary syndrome. Relevant investigative interest has recently been focused on new markers for myocardial injury, including myoglobin, cardiac troponins T and I. Myoglobin, a sensitive but not specific marker for cardiac damage, increases earlier than CK-MB and cardiac troponins. It should be used early after symptom onset and in conjunction with a more specific marker of myocardial damage. Cardiac troponins T and I are highly specific markers for cardiac damage, rise parallel to CK-MB and remain elevated longer, up to 5 to 9 days. They are useful for detection of less severe degrees of myocardial injury, which may occur in several patients with unstable angina who are at higher risk of cardiac events. Recent studies suggest that cardiac troponins have good diagnostic performance and prognostic value in the heterogeneous population of patients seen in the Emergency Department with acute chest pain. Despite these promising data, several analytical and interpretative problems in the routine use of cardiac troponins must be solved. Incremental value of echocardiography in acute chest pain patients is still uncertain. Echocardiography can be recommended as an adjunctive test if readily available during acute chest pain or prolonged pain, especially in patients without previous myocardial infarction. Rest myocardial radionuclide imaging has been studied in the emergency department setting and although the overall diagnostic performance and prognostic value of sestamibi has been found to be promising, it is not suitable, in our country, for extensive clinical use. ECG exercise stress test in the emergency department population has been shown to be safe and it has a good negative predictive value for cardiac events. It should be recommended that any institution identify specific and shared protocol and strategies for management of patients with chest pain. These should include basal clinical evaluation, serial ECG and the use of specific and sensitive myocardial markers. Adjunctive tests, such as echocardiography, nuclear studies and stress tests should be employed when indicated taking into account local facilities.
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Affiliation(s)
- M Cassin
- Unità Operativa di Cardiologia-ARC, Azienda Ospedaliera S. Maria degli Angeli Pordenone.
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Badano L, Solinas L, Cassin M, Zanuttini D. [Inescapable relativity of normal values in echocardiography]. Cardiologia 1999; 44:147-53. [PMID: 10208051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Affiliation(s)
- L Badano
- Uo di Cardiologia, Azienda Ospedaliera S Maria degli Angeli, Associazione per la Ricerca in Cardiologia, Pordenone.
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Badano L, Cassin M, Solinas L, Burelli C, Macor F, Zanuttini D. Clinical impact of local implementation of agreed guidelines for the management of patients with acute myocardial infarction. G Ital Cardiol 1999; 29:39-47. [PMID: 9987046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
OBJECTIVE This study sought to assess the impact of local implementation of clinical practice guidelines on the pattern of care and outcome in patients admitted to the Coronary Care Unit (CCU) with acute myocardial infarction. BACKGROUND Development of clinical practice guidelines is among the most popular of the methods intended to promote translation of results from clinical trials into routine care. However, very little is known about the actual impact on routine care of the clinical guidelines for managing patients with acute myocardial infarction. METHODS We reviewed a prospectively collected cohort of consecutive patients discharged with a diagnosis of acute myocardial infarction from S. Maria degli Angeli, a large community-based hospital in northeast Italy. Eighty-six patients treated in 1996 (before guideline implementation) were compared with 70 patients treated in 1997 (after guideline implementation) with respect to patterns of use of guideline-directed pharmacotherapies for acute myocardial infarction, diagnostic testing, length of CCU stay and clinical outcome. RESULTS The two groups were similar in male gender, age, infarct location and severity. Patients managed before guideline implementation were less likely to receive thrombolysis (36 vs 50%; p = 0.05), i.v. beta-blockers at admission (13 vs 31%; p = 0.002), oral beta-blockers at CCU discharge (45 vs 74%; p = 0.0003). When these were given, patients managed before guideline implementation received lower dosages of i.v. heparin, as manifested by a lower proportion of patients reaching adequate aPTT levels at 24 hours (14 vs 62%, p < 0.0001), and of oral beta-blockers (-50%, p < 0.0001), and higher dosage of aspirin (+100%, p < 0.0001). The time to mobilization (+1 day) and the length of CCU stay (+0.5 day) were longer in patients managed before guideline implementation (p < 0.0001). Incidence of major complications was similar between the two groups (19 vs 13%, respectively; p = ns). CONCLUSIONS Patients with myocardial infarction managed after local implementation of clinical practice guidelines were more likely to receive evidence-based effective pharmacotherapies, and to have earlier mobilization and earlier discharge from CCU. This study strongly supports the role of local implementation of clinical practice guidelines to optimize management of patients with acute myocardial infarction.
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Affiliation(s)
- L Badano
- UO Cardiologia, AO S. Maria degli Angeli and Associazione per la Ricerca in Cardiologia, Pordenone
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Abstract
Very high levels of sCD30, a glycoprotein surface antigen expressed by T lymphocytes and other mononuclear cells of the immune system, were found in serum samples from 10 children with typical Kawasaki disease (KD), but not in blood specimens from a vast cohort of paediatric control subjects. These data strongly support an involvement of CD30 T cells in the immune processes which take place at the level of lymphoid organs during the acute phase of KD.
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Affiliation(s)
- C Vagliasindi
- Department of Paediatrics and Internal Medicine and Oncological Sciences, Perugia University Medical School, Italy
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Meloni T, Solinas L, Erre S, Dore A, Gallisai D, Porqueddu F. The unreliability of mean corpuscular volume and mean cellular hemoglobin determinations in the diagnosis of alpha-thalassemia in newborn infants. Eur J Pediatr 1980; 135:165-7. [PMID: 7449798 DOI: 10.1007/bf00441636] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Mean corpuscular volume (MCV) and mean cellular hemoglobin (MCH) were determined by means of a Hemalog 8/90 electronic counter in 51 full-term newborn infants with alpha-thalassemia-2 and 15 with alpha-thalassemia-1, as well as in 150 normal newborn infants. The mean MCV and MCH values were 92 fl +/- 06 and 33.26 pg +/- 2.22 in the normal newborn infants, 82 fl +/- 07 and 29.40 pg +/- 2.60 in the alpha-thalassemia-2 subjects, and 73 fl +/- 06 and 26.7 +/- 2.05 in the alpha-thalassemia-1 subjects. Four of the 150 normal newborn infants had MCV's < 79 fl and MCH's < 29.00 pg whereas 5 of the alpha-thalassemic subjects had MCV's > 90 fl and MCH's > 32.00 pg. We conclude that MCV and MCH determinations are unreliable in the diagnosis of alpha-thalassemia in the neonatal period.
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Villanti P, Calabrò R, Mei V, Solinas L. [Induction in vitro of resistance to tetrabiguanide in some bacterial strains]. Boll Soc Ital Biol Sper 1967; 43:1743-1744. [PMID: 5589104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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