In 1982 a programme of multi-disciplinary follow-up on 12 patients that underwent a gastric tube oesophagoplasty for long-gap oesophageal atresia was started. Radiological examination, performed on all gastric tubes but one (died a few days after surgery), assessed the morphology and dynamics of gastric tube, either distally or proximally based, and stomach 2 to 8 years after surgery. Endoscopic backward exploration was performed on 7 cases, to allow a closer analysis of stomach, gastric tube mucosa and upper oesophageal stump, demonstrating that the gastric transplant is viable and almost undamaged. No evidence of oesophagitis of the proximal stump was found. Histological stainings on biopsy specimens and on sections from one post-mortem examination, showed a mild degree of dystrophy in gastric tube mucosa, progressively shading into proper gastric mucosa. No evidence of a progressive change for the worse was found in any of the 7 tubes controlled.
Introduction: Mammography is one of the most technically demanding radiographic processes, and mammography quality assurance initiatives are priorities in the implementation of public health screening services. In the optimisation of image quality (IQ), radiographers play a major role. Between 1998 and 2009, the steering committee for mammography of a large population-based screening service in northern Italy undertook several audit checks of the imaging facilities. In 2009, the target age range of the screening service was extended. The mammogram volume was projected to increase steeply but with no substantial increase in the radiographer workforce. Methods: In view of the potential impact on mammographic IQ, the passive audit approach was abandoned in favour of an active radiographer-oriented IQ review programme. Its technical basis consists of regularly repeated rounds of review of random samples of digital mammograms performed by each firstlevel radiographer and by more experienced local reference radiographers, with IQ classification, followed by a training effort and a monitoring work. Results: The mammogram volume grew from 140,822 in 2008 to 319,394 in 2014 (+127%) and then stabilised. In 2012, the proportion of mammograms with a poor IQ rose from 0.6% to 19.3%, paralleled by a substantial decrease of mammograms interpreted to have a moderate and perfect IQ. Conversely, a generalised improvement occurred in both rounds of 2016 and in the first round of 2018. Conclusion: In the new challenging scenario, the programme proved to be effective. A successful IQ review initiative is one that encourages radiographers to participate with a positive and confident attitude.
Introduction:In the province of Modena an agreement between the Local Authority for Health (Azienda Sanitaria Locale, ASL) of Modena and the General Practioners (GPs) is in force since 2002. It consists of a protocol for integrated care of people with dementia (PWD) and their families between GPs and the Specialist centres for cognitive disorders, divided into two stages: 1) Taking charge of the patient by the GP (module A) ; 2) Follow-up care management, with annual reporting by the GP to the ASL by means of a pre-set paper module (module B) containing besides patients' demographic characteristics, clinical and therapeutic data. The objective of this project is to monitor the condition of both the patient and the family in order to promptly alert the social services and the network of integrated health and social services in the attempt to delay and/or prevent hospitalisations and/or inappropriate institutionalisation of PWD.
Aim: To verify the appropriateness of the 2013 compilation of Modules B by GPs in the HealthDistrict of Mirandola relative to some variables considered important not only for more epidemiological reasons (prevalence of three levels of cognitive impairment: "mild cognitive impairment" [MCI]; "definite cognitive decline" [DCD]; "cognitive decline with depression" [CDDep+]), but also for the care solutions to be offered to the families on the basis of the progression of dementia (improved-stable-worsened) and the families' endurance in taking care for PWD at home (satisfactory-difficult-unmanageable).
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