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[PMID]:29377920
[Au] Autor:Bonanomi S; Pulcinella J; Fortuna CM; Moro F; Sala A
[Ad] Endereço:Italian National Research Council (CNR), Institute of Marine Sciences (ISMAR), Ancona, Italy.
[Ti] Título:Elasmobranch bycatch in the Italian Adriatic pelagic trawl fishery.
[So] Source:PLoS One;13(1):e0191647, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Elasmobranchs are among the most threatened long-lived marine species worldwide, and incidental capture is a major source of mortality. The northern central Adriatic Sea, though one of the most overfished basins of the Mediterranean Sea, supports a very valuable marine biodiversity, including elasmobranchs. This study assesses the impact of the northern central Adriatic pelagic trawl fishery on common smooth-hound (Mustelus mustelus), spiny dogfish (Squalus acanthias), common eagle ray (Myliobatis aquila), and pelagic stingray (Pteroplatytrygon violacea) by examining incidental catches recorded between 2006 and 2015. The distribution of bycatch events was evaluated using geo-referenced data. Generalized Linear Models were computed to standardize the catch of the four species and to predict the relative abundance of bycatch events. Data analysis shows that most bycatch events involving all four species occurred in the northern Adriatic Sea. The models predicted significant, distinct temporal patterns of standardized catches in line with previous investigations. Water depth, season, and fishing region were the best predictors to explain bycatch events. The present data suggest that the northern Adriatic may be an important nursery area for several elasmobranchs. They also highlight the urgent need for a better understanding of the interactions between elasmobranchs and fisheries to develop and apply suitable, ad hoc management measures.
[Mh] Termos MeSH primário: Elasmobrânquios
Pesqueiros
[Mh] Termos MeSH secundário: Animais
Itália
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180130
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191647


  2 / 76906 MEDLINE  
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[PMID]:29329310
[Au] Autor:Bonaudo M; Martorana M; Dimonte V; D'Alfonso A; Fornero G; Politano G; Gianino MM
[Ad] Endereço:Department of Public Health Sciences and Pediatrics, Università di Torino, Torino, Italy.
[Ti] Título:Medication discrepancies across multiple care transitions: A retrospective longitudinal cohort study in Italy.
[So] Source:PLoS One;13(1):e0191028, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Medication discrepancies are defined as unexplained differences among regimens across different sites of care. The problem of medication discrepancies that occur during the entire care pathway from hospital admission to a local care setting discharge (namely all types of settings dedicated to formal care other than hospitals) has received little attention in the medical literature. The present study aims to (1) determine the prevalence of medication discrepancies that occur during the entire care pathway from hospital admission to local care setting discharge, (2) describe the discrepancy and medication type, and (3) identify potential risk factors for experiencing medication discrepancies in patient care transitions. Evidence from an integrated health care system, such as the Italian one, may explain results from other studies in different healthcare systems. METHODS: A retrospective longitudinal cohort study of patients admitted from July 2015 to July 2016 to the Giovanni Bosco Hospital serving Turin, Italy and its surrounding territory was performed. Discrepancies were recorded at the following four care transitions: T1: Hospital admission; T2: Hospital discharge; T3: Admission into local care settings; T4: Discharge from local care settings. All evaluations were based on documented regimens and were performed by a team (doctor, nurse and pharmacists). RESULTS: Of 366 included patients, 25.68% had at least one discrepancy. The most frequent type of discrepancy was from medication omission (N = 74; 71.15%). Only discharge from a long-stay care setting (T4) was significantly associated with the onset of discrepancies (p = 0.045). When considering a lack of adequate documentation, not as missing data but as a discrepancy, 43.72% of patients had at least one discrepancy. CONCLUSIONS: This study suggests that an integrated health care system, such as Italian system, may influence the prevalence of discrepancies, thus highlighting the need for structured multidisciplinary and, if possible, computerized medication reconciliation to prevent medication discrepancies and improve the quality of medical documentation.
[Mh] Termos MeSH primário: Continuidade da Assistência ao Paciente
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Feminino
Seres Humanos
Itália
Estudos Longitudinais
Masculino
Meia-Idade
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180113
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191028


  3 / 76906 MEDLINE  
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[PMID]:29258563
[Au] Autor:Treitler JT; Drissen T; Stadtmann R; Zerbe S; Mantilla-Contreras J
[Ad] Endereço:RG Ecology and Environmental Education, Institute of Biology and Chemistry, University of Hildesheim, Universitätsplatz 1, 31141, Hildesheim, Germany. treitler@uni-hildesheim.de.
[Ti] Título:Complementing endozoochorous seed dispersal patterns by donkeys and goats in a semi-natural island ecosystem.
[So] Source:BMC Ecol;17(1):42, 2017 Dec 19.
[Is] ISSN:1472-6785
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Endozoochory is, in grazing systems, a substantial vector for seed dispersal. It can play an important role in vegetation dynamics, especially in colonization processes through seed input on the vegetation and on the soil seed bank. We investigated the endozoochorous seed input of donkeys and goats on a semi-natural island ecosystem in the Mediterranean. Through germination experiments, we assessed the viable seed content of the dung of these grazing animals to estimate their suitability and efficiency for seed dispersal of the vegetation types of the island. RESULTS: We show different dispersal patterns of donkeys and goats. Goats disperse a high number of diaspores from shrubs while donkeys disperse more diaspores of grasses. In addition, goats disperse plants of greater growth height and donkeys plants of shorter height. These dispersal patterns are in accordance with the vegetation types of which donkeys and goats disperse indicator species. Both, donkeys and goats, feed on and disperse species of the vegetation types, open grassland and temporarily wet grassland. In addition, goats feed on and disperse diagnostic species of the semi-open maquis and preforest formations. CONCLUSIONS: Overall, our results show that donkeys and goats are complementing each other in their endozoochorous seed dispersal potential. This emphasizes the importance of both grazing animals for the vegetation dynamics of the semi-natural island ecosystem. Therefore, the adaption of the goat management to a traditional land management based on directed transhumance might maintain and enrich vegetation types.
[Mh] Termos MeSH primário: Equidae/fisiologia
Cabras/fisiologia
Herbivoria
Dispersão de Sementes
[Mh] Termos MeSH secundário: Animais
Ilhas
Itália
Estações do Ano
Especificidade da Espécie
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171221
[St] Status:MEDLINE
[do] DOI:10.1186/s12898-017-0148-6


  4 / 76906 MEDLINE  
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[PMID]:28934713
[Au] Autor:Cacciatore F; Boscolo Brusà R; Noventa S; Antonini C; Moschino V; Formalewicz M; Gion C; Berto D; Gabellini M; Marin MG
[Ad] Endereço:ISPRA - Institute for Environmental Protection and Research, Loc. Brondolo, 30015 Chioggia, Italy. Electronic address: federica.cacciatore@isprambiente.it.
[Ti] Título:Imposex levels and butyltin compounds (BTs) in Hexaplex trunculus (Linnaeus, 1758) from the northern Adriatic Sea (Italy): Ecological risk assessment before and after the ban.
[So] Source:Ecotoxicol Environ Saf;147:688-698, 2018 Jan.
[Is] ISSN:1090-2414
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:The aim of this study was to compare imposex and butyltin compounds (BTs) data, collected before and after the organotin ban in 2008, in order to assess temporal and spatial variation of the phenomenon, the decline of BT contamination, and the effects on Hexaplex trunculus population in the coastal area of the northern Adriatic Sea, close to the Venice Lagoon. Both in marine and in lagoon sites, the results obtained in 2013-2015 showed a significant decline in the incidence of imposex in respect to those from the 2002 survey. In 2002, lagoon samples exhibited Relative Penis Size Index (RPSI) higher than marine samples, whereas no differences were detected in the recent survey, when all RPSI values were below 0.6%. Vas Deference Sequence Index (VDSI) mean values were over 4 before the ban introduction and below this value after that, indicating more critical conditions for gastropod population in 2002 rather than in 2013-15. Percentage of sterile females was up to 69% in 2002, whilst in the more recent survey no sterile female was found. Range of BT concentrations in gastropods decreased from 252 to 579 to 16-31ng∑BT/g d.w. BT body burdens varied according to a gender dependant pattern, with higher concentrations observed in females than in males. A first attempt to propose a classification based on BT impact on H. trunculus, according to the Water Framework Directive, revealed that most sites were in Bad ecological status before the ban and attained a Poor/Moderate status after that.
[Mh] Termos MeSH primário: Transtornos do Desenvolvimento Sexual/induzido quimicamente
Monitoramento Ambiental/métodos
Gastrópodes/efeitos dos fármacos
Compostos de Trialquitina/toxicidade
Poluentes Químicos da Água/toxicidade
[Mh] Termos MeSH secundário: Animais
Carga Corporal (Radioterapia)
Feminino
Gastrópodes/metabolismo
Itália
Masculino
Mar Mediterrâneo
Medição de Risco
Água do Mar/química
Compostos de Trialquitina/metabolismo
Poluentes Químicos da Água/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Trialkyltin Compounds); 0 (Water Pollutants, Chemical); 4XDX163P3D (tributyltin)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170922
[St] Status:MEDLINE


  5 / 76906 MEDLINE  
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[PMID]:28746168
[Au] Autor:Pittalis S; Orchi N; De Carli G; Navarra A; Chiaradia G; Puro V; Girardi E
[Ad] Endereço:*Clinical Epidemiology Unit, National Institute for Infectious Disease "L. Spallanzani"-IRCCS, Rome, Italy †Infectious Disease Epidemiology Unit, AIDS Reference Centre, National Institute for Infectious Disease "L. Spallanzani"-IRCCS, Rome, Italy.
[Ti] Título:HIV Self-Testing in Italy.
[So] Source:J Acquir Immune Defic Syndr;76(3):e84-e85, 2017 11 01.
[Is] ISSN:1944-7884
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Sorodiagnóstico da AIDS
Infecções por HIV/diagnóstico
Acesso aos Serviços de Saúde/estatística & dados numéricos
Kit de Reagentes para Diagnóstico/utilização
Autocuidado
[Mh] Termos MeSH secundário: Sorodiagnóstico da AIDS/utilização
Adulto
Aconselhamento Diretivo
Infecções por HIV/epidemiologia
Conhecimentos, Atitudes e Prática em Saúde
Promoção da Saúde
Homossexualidade Masculina
Seres Humanos
Itália/epidemiologia
Masculino
Estudos Prospectivos
Adulto Jovem
[Pt] Tipo de publicação:LETTER; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Reagent Kits, Diagnostic)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM; X
[Da] Data de entrada para processamento:170727
[St] Status:MEDLINE
[do] DOI:10.1097/QAI.0000000000001507


  6 / 76906 MEDLINE  
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[PMID]:28457513
[Au] Autor:Bonsignore A; Orcioni GF; Barranco R; De Stefano F; Ravetti JL; Ventura F
[Ad] Endereço:University of Genova, Department of Legal and Forensic Medicine, Via De Toni 12, Genova 16132, Italy.
[Ti] Título:Fatal disseminated histoplasmosis presenting as FUO in an immunocompetent Italian host.
[So] Source:Leg Med (Tokyo);25:66-70, 2017 Mar.
[Is] ISSN:1873-4162
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:Histoplasmosis is a relatively rare infectious disease endemic to certain geographic areas such as East Africa, eastern and central United States, western Mexico, Central and South America. Disseminated histoplasmosis has been reported mainly in immunocompromised hosts and in AIDS patients. In this paper we report on a fatal case of undiagnosed disseminated histoplasmosis presenting as fever of unknown origin (FUO) in a 43-year-old Italian woman who, although splenectomized 5years earlier due to a motor vehicle accident, was otherwise immunocompetent. This case report highlights the fact that, even in Europe, histoplasmosis is an emerging sporadic infection which needs be considered in the differential diagnosis of given clinical scenarios. The proposed case is of blatant forensic concern as it addresses the hypothesis of professional responsibility due to a missed diagnosis of histoplasmosis. A timely diagnosis, with appropriate therapies, could have prevented death. The role of the forensic pathologist is also crucial because the post-mortem diagnosis of histoplasmosis (never considered in the differential diagnosis during prior hospitalization) highlights the importance of a meticulous and thorough autopsy to elucidate the cause of death.
[Mh] Termos MeSH primário: Diagnóstico Tardio
Febre de Causa Desconhecida/diagnóstico
Histoplasmose/diagnóstico
Histoplasmose/patologia
Hospedeiro Imunocomprometido
[Mh] Termos MeSH secundário: Adulto
Autopsia
Evolução Fatal
Feminino
Seres Humanos
Itália
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE


  7 / 76906 MEDLINE  
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[PMID]:28453829
[Au] Autor:Tereanu C; Smith SA; Sampietro G; Sarnataro F; Mazzoleni G; Pesenti B; Sala LC; Cecchetti R; Arvati M; Brioschi D; Viscardi M; Prati C; Barbaglio GG
[Ad] Endereço:Department of Hygiene and Prevention, Agenzia di Tutela della Salute, Via Borgo Palazzo n. 130, 24125 Bergamo, Italy.
[Ti] Título:Experimenting the hospital survey on patient safety culture in prevention facilities in Italy: psychometric properties.
[So] Source:Int J Qual Health Care;29(2):269-275, 2017 Apr 01.
[Is] ISSN:1464-3677
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Objective: The Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture (HSOPS) was designed to assess staff views on patient safety culture in hospital. This study examines psychometrics of the Italian translation of the HSOPS for use in territorial prevention facilities. Design: After minimal adjustments and pre-test of the Italian version, a qualitative cross-sectional study was carried out. Setting: Departments of Prevention (DPs) of four Local Health Authorities in Northern Italy. Participants: Census of medical and non-medical staff (n. 479). Intervention: Web-based self-administered questionnaire. Main outcome measures: Descriptive statistics, internal reliability, Confirmatory Factor Analysis (CFA) and intercorrelations among survey composites. Results: Initial CFA of the 12 patient safety culture composites and 42 items included in the original version of the questionnaire revealed that two dimensions (Staffing and Overall Perception of Patient Safety) and nine individual items did not perform well among Italian territorial Prevention staff. After dropping those composites and items, psychometric properties were acceptable (comparative fit index = 0.94; root mean square error of approximation = 0.04; standardized root mean square residual = 0.04). Internal consistency for each remaining composite met or exceeded the criterion 0.70. Intercorrelations were all statistically significant. Conclusions: Psychometric analyses provided overall support for 10 of the 12 initial patient safety culture composites and 33 of the 42 initial composite items. Although the original instrument was intended for US Hospitals, the Italian translation of the HSOPS adapted for use in territorial prevention facilities performed adequately in Italian DPs.
[Mh] Termos MeSH primário: Segurança do Paciente
Psicometria/estatística & dados numéricos
Gestão da Segurança
Inquéritos e Questionários
[Mh] Termos MeSH secundário: Atitude do Pessoal de Saúde
Estudos Transversais
Pessoal de Saúde/psicologia
Pessoal de Saúde/estatística & dados numéricos
Seres Humanos
Itália
Saúde Pública
Reprodutibilidade dos Testes
Traduções
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1093/intqhc/mzx014


  8 / 76906 MEDLINE  
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[PMID]:28453826
[Au] Autor:Casalini F; Salvetti S; Memmini S; Lucaccini E; Massimetti G; Lopalco PL; Privitera GP
[Ad] Endereço:Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via San Zeno 37, 56127 Pisa, Italy.
[Ti] Título:Unplanned readmissions within 30 days after discharge: improving quality through easy prediction.
[So] Source:Int J Qual Health Care;29(2):256-261, 2017 Apr 01.
[Is] ISSN:1464-3677
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Objective: To propose an easy predictive model for the risk of rehospitalization, built from hospital administrative data, in order to prevent repeated admissions and to improve transitional care. Design: Retrospective cohort study. Setting: Azienda Ospedaliero Universitaria Pisana (Pisa University Hospital). Participants: Patients residing in the territory of the province of Pisa (Tuscany Region) with at least one unplanned hospital admission leading to a medical Diagnosis-Related Group (DRG) in the calendar year 2012. Intervention: We compared two groups of patients: patients coded as 'RA30' (readmitted within 30 days after the previous discharge) and patients coded as 'NRA30' (either admitted only once or readmitted after 30 days since the latest discharge). Main Outcome Measures: The effect of age, sex, length of stay, number of diagnoses, normalized number of admissions and presence of diseases on the probability of rehospitalization within 30 days after discharge was evaluated. Results: The significant variables included in the predictive model were: age, odds ratio (OR) = 1.018, 95% confidence interval (CI) = 1.011-1.026; normalized number of admissions, OR = 1.257, CI = 1.225-1.290; number of diagnoses, OR = 1.306, CI = 1.174-1.452 and presence of cancer diagnosis, OR = 1.479, CI = 1.088-2.011. Conclusions: The model can be easily applied when discharging patients who have been hospitalized after an access to the Emergency Department to predict the risk of rehospitalization within 30 days. The prediction can be used to activate focused hospital-primary care transitional interventions. The model has to be validated first in order to be implemented in clinical practice.
[Mh] Termos MeSH primário: Modelos Teóricos
Readmissão do Paciente/estatística & dados numéricos
Qualidade da Assistência à Saúde/estatística & dados numéricos
[Mh] Termos MeSH secundário: Fatores Etários
Estudos de Coortes
Comorbidade
Serviço Hospitalar de Emergência/estatística & dados numéricos
Feminino
Previsões
Seres Humanos
Itália/epidemiologia
Tempo de Internação
Masculino
Neoplasias
Estudos Retrospectivos
Fatores de Risco
Fatores Sexuais
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1093/intqhc/mzx011


  9 / 76906 MEDLINE  
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[PMID]:28453824
[Au] Autor:Tricarico P; Castriotta L; Battistella C; Bellomo F; Cattani G; Grillone L; Degan S; De Corti D; Brusaferro S
[Ad] Endereço:Dipartimento di Scienze Mediche e Biologiche (Department of Medical and Biological Sciences), Università degli Studi di Udine (University of Udine), Piazzale Kolbe 4, 33100 Udine, Italy.
[Ti] Título:Professional attitudes toward incident reporting: can we measure and compare improvements in patient safety culture?
[So] Source:Int J Qual Health Care;29(2):243-249, 2017 Apr 01.
[Is] ISSN:1464-3677
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Objective: To establish categories of professionals' attitudes toward incident reporting by analyzing the trends in incident reporting while accounting for general risk indicators. Design: The incident reporting system was evaluated over 6 years. Reporting rates, stratified by year and profession, were estimated using the non-mandatory reported events/full-time equivalent (NM-IR/FTE) rate. Other indicators were collected using the hospital's official database. Staff attitudes toward self-reporting were analyzed. Univariate and multivariable analyses were performed. Setting: A 1000-bed Italian academic hospital. Participants: Staff of the hospital (over 3200 professionals). Interventions: None. Main outcome measures: NM-IT/FTE rates, self-reported rates, patient complaints/praises, work accidents among professionals and 30-day readmissions. Results: The overall reporting rate was 0.44 (95% confidence interval [CI]: 0.42-0.46) among doctors and 0.40 (95% CI: 0.39-0.41) among nurses. Between 2010 and 2015, only the doctors' reporting rate increased significantly (P = 0.04), from 0.29 (95% CI: 0.25-0.34) to 0.67 (95% CI: 0.60-0.73). Patient complaints decreased from 384 to 224 (P < 0.001) and work accidents decreased from 296 to 235 (P = 0.01), while other indicators remained constant. Multivariable logistic regression showed that self-reporting was more likely among nurses than doctors (odds ratio: 1.51; 95% CI: 1.31-1.73) and for severe events than near misses (odds ratio: 1.78; 95% CI: 1.11-2.87). Conclusions: Because the doctors' reporting rates increased during the study period, doctors may be more likely to report adverse events than nurses, although nurses reported more events. Incident reporting trends and other routinely collected risk indicators may be useful to improve our understanding and measurement of patient safety issues.
[Mh] Termos MeSH primário: Atitude do Pessoal de Saúde
Segurança do Paciente
Gestão de Riscos/tendências
Gestão da Segurança/tendências
[Mh] Termos MeSH secundário: Centros Médicos Acadêmicos
Acidentes de Trabalho/estatística & dados numéricos
Feminino
Seres Humanos
Itália
Masculino
Corpo Clínico Hospitalar/psicologia
Readmissão do Paciente/estatística & dados numéricos
Satisfação do Paciente/estatística & dados numéricos
Autorrelato
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1093/intqhc/mzx004


  10 / 76906 MEDLINE  
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[PMID]:28451755
[Au] Autor:Bosi M; De Vito A; Bellini C; D'Agostino G; Firinu E; Gobbi R; Pacella A; Filograna Pignatelli G; Zeccardo E; Poletti V; Vicini C
[Ad] Endereço:Department of Diseases of the Thorax, GB Morgagni-Pierantoni Hospital, AUSL of Romagna, Forlì, Italy.
[Ti] Título:The interpretation of compact polysomnography/polygraphy in sleep breathing disorders patients: a validation's study.
[So] Source:Eur Arch Otorhinolaryngol;274(8):3251-3257, 2017 Aug.
[Is] ISSN:1434-4726
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:The Otorhinolaryngologist (ENT) frequently has to deal with OSA or suspicious OSA patients and undergone polysomnography (PSG) or portable monitoring (PM) and should be confident about the quality and consistency of the polysomnographic diagnosis. The main polysomnographic traces compressed in a unique epoch, defined as compact PSG/PM (CP), could represent an efficient tool to confirm the quality of PSG/PM Sleep Breathing Disorders diagnosis. This is a validation's study of a CP interpretation's method, analyzing the learning curve, the level of diagnostic accuracy, and the inter-operator agreement in interpreting the CP pattern between a group of ENT specialists not skilled in PSG/PM scoring, but managing SBD patients during daily practice. Seven ENT specialists have been enrolled in the study. 50 CP traces (ranging from normal to all main SBD patterns) have been showed to each participant for the interpretation and scoring process, before and after a 2-h theoretical-practical interactive lesson, focusing on the recognition of the four main oximetric patterns on CP traces (normal, phasic, prolonged, and overlap patterns). RESULTS: before and after the theoretical-practical interactive lesson, the whole diagnostic accuracy in interpreting the 50 CP has been reported improved from 0.12 to 0.80 (median 0.52) to 0.82-0.96 (median 0.92) (p = 0.006) and the inter-scorers' agreement showed a kappa value increased from of 0.18 to 0.75 (p < 0.0001). A complete clinical diagnostic evaluation is essential in OSA patients and the ENT specialist should be concerned to verify if the patient, suitable for surgical therapy, is affected really by an isolated form of OSA. The CP interpretation allows a checking of the proper nosographic SBD framework and could be significantly important for all ENT specialists not skilled in PSG/PM scoring, but managing SBD patients during daily practice. The data reported in our validation's study showed that the CP interpretation's method is easy to apply, with a rapid learning curve. The level of diagnostic accuracy is high with a high inter-scorer agreement in interpreting the CP patterns.
[Mh] Termos MeSH primário: Otolaringologia/educação
Testes Imediatos/normas
Polissonografia
Síndromes da Apneia do Sono/diagnóstico
[Mh] Termos MeSH secundário: Precisão da Medição Dimensional
Feminino
Seres Humanos
Itália
Curva de Aprendizado
Masculino
Meia-Idade
Oximetria/métodos
Administração dos Cuidados ao Paciente/métodos
Administração dos Cuidados ao Paciente/normas
Polissonografia/métodos
Polissonografia/normas
Desenvolvimento de Pessoal/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE; VALIDATION STUDIES
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1007/s00405-017-4578-8



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