Nella teoria bio-psico-sociale, la visione salutogenetica (Antonowsky, 1979) è volta a promuovere il benessere. La promozione della salute indica un processo di cambiamento e sviluppo adattivo diretto alla prevenzione primaria, secondaria e terziaria attraverso la diffusione di stili di vita sani. Nel presente lavoro si propone un modello di salutogenesi: “I Salotti del Ben-Essere” (S. Diamare, 2015), sperimentato dall'ASL NA 1 Centro UOC. Qualità e Umanizzazione, che prevede lo gv. sviluppo di tematiche di salutogenesi in laboratori esperienziali di consapevolezza psico-corporea, implementato in Campania attraverso la rete OMS di Promozione della Salute: Health Promoting Hospitals & Health Service (HPH & HS). Quale approccio olistico di Health Advocacy, I Salotti del Ben-Essere© rappresentano uno spazio multicentrico e multiprofessionale di assistenza partecipativa, rivolta a piccoli gruppi ed a comunità, in cui un team specializzato realizza un programma multidisciplinare di educazione sanitaria prevalentemente in un setting di riabilitazione. L’educazione alla salute trova, durante un trattamento riabilitativo, la collocazione più proficua per sostenere la motivazione al cambiamento consapevole di stili di vita perniciosi. Il metodo "Salotti del Ben-Essere" può essere utilizzato, come Peer Education, anche nel sistema universitario. Questa metodologia è stata testata, infatti, con gli studenti di Scienze dell'Educazione presso l’Università Suor Orsola Benincasa. I risultati sono stati soddisfacenti in tutti i contesti.
Aim and objectives To evaluate the effectiveness of alirocumab and evolocumab in reducing low density lipoprotein cholesterol (LDL-c) and RCE in patients with poorly controlled hyperlipidaemia. Material and methods This was an observational and retrospective study which included every patient treated with alirocumab and evolocumab between March 2016 and September 2019. Demographics and clinical variables were collected from the electronic medical records: sex, age, drug, dose, frequency of administration, previous hypolipaemic treatment, causes of suspension and analytical parameters at the start of treatment, and after 12 weeks and 24 weeks (total cholesterol (TC), LDL-c, high density lipoprotein (HDL)-cholesterol and triglycerides). To assess RCE, the Framingham scale was used, and if patients were diabetic or smokers was also recorded. To assess effectiveness, we calculated the percentage reduction (PR) of TC, LDL-c and RCE. Adverse effects (AE) were recorded to assess safety. Results Forty-six patients were included (76% men, average age 60.8 (SD 11.1) years: 24 were treated with alirocumab and 22 with evolocumab. Median duration of treatment was 27.2 months (0.2-43.8). At drug initiation, 71.7% of patients were on high dose statins and 76.1% were on ezetimibe as an adjuvant. Six patients discontinued treatment: 4 for toxicity, 1 for associated pathology and 1 due to loss of follow up.
Background Spasticity is a common and disabling symptom of multiple sclerosis (MS). The management of MS spasticity is centred around relief and functional improvement, evaluated with the Expanded Disability Status Scale (EDSS). Sativex oromucosal spray is a cannabinoid-based medicine used for adult MS patients with moderate to severe spasticity who do not respond adequately to first-line antispasticity medications. The patients who responded to Sativex showed an improvement from baseline in spasticity !20%-30% evaluated with a numerical rating scale (NRS) scores. 1 Purpose The aim of the study was to review the use of oromucosal spray Sativex in patients with moderate to severe MS. Material and methods A retrospective cohort study was conducted in patients who began using Sativex between January 2016 and June 2018. The data was retrieved from the webbased register of the Italian Medicines Agency. The primary endpoint was the change in the degree of severity of spasticity assessed by the NRS scale and the evaluation of adverse effects in order to assess safety. The efficacy of Sativex was established by a medium reduction of 20%, according to the NRS scale, from the value at the baseline to the value of the last re-evaluation of the disease. The adverse effects were evaluated during the whole period considered. Results Thirty-seven patients were evaluated, 70.27% of these were female. The medium age was 56±9 years, the mean NRS and the mean EDSS score before treatment was 7.86 ±1.00 and 5.95±1,47, respectively. A medium correlation was found between NRS and EDSS score (R=0.669; F=29.903; p<0.0001). The NRS score after treatment was 5.66±1.04 (D= À2,20±0.68), with a statistical significance (Z=-5,829; p<0.00001). All patients obtained a reduction >20% of the NRS score. The adverse effects detected were fatigue (8.1%), nausea (5.4%), headache (5.4%) and vertigo (2.7%). Conclusion The symptomatic relief of spasticity led to quantifiable benefits in the ability to perform daily activities and it improved the patients' quality of life. These findings are in line with other studies, which show the use of Sativex as effective and well tolerated for the management of the spasticity of patients with MS with moderate to severe grade symptoms.
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