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Gozzi E, La Manna AR, Rossi L, Colonna M, Ulgiati MA, Romagnoli L, Busco S, Parrocchia S, Marrone R, Iavarone C, Arcangeli G, Angelini F, De Masi C, Ambrogi C, Travaini S, Calogero A, Centra A, Ricci F. What hides beneath the scar: sexuality and breast cancer what women don't say: A single-center study. Clin Ter 2022; 173:342-346. [PMID: 35857051 DOI: 10.7417/ct.2022.2443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Breast is a symbol of femininity, motherhood and sexuality. Breast cancer (BC) is the leading cause of cancer death in women worldwide and most frequent cancer in Italy: in 2019, 53.500 new cases were diagnosed. BC and its treatment, the disturbances of body image, and mental health problems such as anxiety and depression could influence sexuality. Very often the aspect of sexuality in BC is likely not to be fully investigated: cultural barriers may also contribute to lack of attention to these issues. In Italy, there are very few Breast Units that provide the figure of the sexologist and psycho-oncologist. METHODS We enlisted 141 BC patients (pts), mean age was 54 years afferent to Breast Unit S. Maria Goretti Hospital, Latina, from March 2019 to March 2020. All pts had undergone surgical intervention. Participants were invited to complete a structured questionnaire, which included four close-up questions regarding self-image, sexual activity, sexual satisfaction, analyzing these aspects before and after BC and its treatments. Finally the participants were asked if they needed the sexologist and psycho-oncologist. RESULTS Only 2/141 pts (1.41%) refused to participate in our study. Of 139 participants, 68 (48.92%) had disturbances of body image, 26 (18.7%) had sexuality greatly negatively affected, and 103 (74.1%) every kind of sexual dissatisfaction after BC. 38 pts (27.3%) would require the help of the sexologist. 135 ( 97%) would require the help of the psycho-oncologist. Despite the negative influence in their body-image and sexuality, few pts require the help of the sexologist, but nearly all pts require the help of the psycho-oncologist. CONCLUSION In our study nearly all pts require the help of the psycho-oncologist, but few pts of the sexologist. Further studies will be needed to understand the reasons for this disparity: at the moment we are carrying out another project following this illustration, with the aim of understanding why this disparity.
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Affiliation(s)
- E Gozzi
- Medical Oncology Unit, Regina Apostolorum Hospital, Albano, Rome, Italy
| | - A R La Manna
- UOC Breast Unit Latina, S. Maria Goretti Hospital, Latina, Italy
| | - L Rossi
- UOC of Oncology - ASL Latina - Distretto 1, University of Rome "Sapienza", Aprilia (LT), Italy
| | - M Colonna
- UOSD of Oncology - A. Fiorini Hospital Terracina, Italy
| | - M A Ulgiati
- UOC Breast Unit Latina, S. Maria Goretti Hospital, Latina, Italy
| | - L Romagnoli
- UOC of Clinical Control And Governance Programming - ASL Latina. Italy
| | - S Busco
- UOC of Clinical Control And Governance Programming - ASL Latina. Italy
| | - S Parrocchia
- UOC of Medical Direction S. Maria Goretti Hospital, Latina, Italy
| | - R Marrone
- UOC of Medical Direction S. Maria Goretti Hospital, Latina, Italy
| | - C Iavarone
- UOC of Anesthesia S. Maria Goretti Hospital, Latina, Italy
| | - G Arcangeli
- UOC of Radiotherapy S. Maria Goretti Hospital, Latina, Italy
| | - F Angelini
- Medical Oncology Unit, Regina Apostolorum Hospital, Albano, Rome, Italy
| | - C De Masi
- UOC of Diagnostic And Interventional Radiology, S. Maria Goretti Hospital, Latina, Italy
| | - C Ambrogi
- UOC of Diagnostic And Interventional Radiology, S. Maria Goretti Hospital, Latina, Italy
| | - S Travaini
- UOC Anatomia Patologica S. Maria Goretti Hospital, Latina, Italy
| | - A Calogero
- Dipartimento di Scienze e Biotecnologie Medico-Chirurgiche, Sapienza, Latina, Italy
| | - A Centra
- UOC of Information flows and process innovations ASL Latina, Italy
| | - F Ricci
- UOC Breast Unit Latina, S. Maria Goretti Hospital, Latina, Italy
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Nasi G, Brandimarte G, Marrone R, Sponzilli A, Sorbara D, Benedetti P, Grande D, Brando C, D'Avino A, Parrocchia S. Benchmarking between two different hospitals on health risk management in the covid-19 emergency. Eur J Public Health 2021. [PMCID: PMC8574661 DOI: 10.1093/eurpub/ckab165.362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Iusse The strategies adopted during COVID19 emergencies by two different hospitals in the Lazio Region are presented: S. Maria Goretti Hospital (SMGH) directly managed by the ASL Latina, hub and centre of the Emergency Department, and Cristo Re Classified Hospital (CRH), accredited in the territory of the ASL Roma1. Description of the problem SMGH has been identified as COVID19 Intervention Hospital. CRH initially was a No-COVID support structure, then included in the COVID19 network. During the COVID19 emergency, the directors of both hospitals had to simultaneously ensure activity as usual, COVID19 recovery and risk management. Results SMGH, while continuing the emergency, oncological, pregnancy, paediatrics and outpatient activities, COVID19 patients was isolated on 7 different floors/areas. Moreover was defined: chain of command; clinical admission criteria; COVID19 multi-professional and support teams, roles, skills and specific training; health surveillance; environmental hygiene, safety paths/procedures, vaccinal center and much more. CRH, while continuing minimum programmed activities to reduce waiting lists, in the first epidemic phase was created 4 tensile structures for Pre-triage and COVID pathways, respiratory isolation area for supsected patient; transfer admission for emergency networks, clean-dirty pathway. Moreover in the second phase, was activated beds of COVID19 network and 4 technical beds OBI; the ‘Walk-in' for antigenic testing, with molecular confirmation <24h and infectious counselling; multi-disciplinary and specialist support teams, training courses, health surveillance, vaccinal center and much more. Lessons During COVID19 pandemic, risk management skills linked to the technical-organisational strategy of hospital directors, making it possible to reprogramme their structure in a short period of time with flexibility and resilience of the whole organization. Key messages Specific skills and roles, both hygienic and organizational, are essential to risk management in hospitals during epidemic emergencies. The multidisciplinarity, flexibility and modularity of the hospital structure are the organizational bases in cases of pandemics.
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Affiliation(s)
- G Nasi
- Department of Health Management, Cristo Re Hospital, Rome, Italy
| | - G Brandimarte
- Division of Internal Medicine and Gastroenterology, Cristo Re Hospital, Rome, Italy
| | - R Marrone
- Department of Health Management, S.M. Goretti Hospital, Latina, Italy
| | - A Sponzilli
- Operation Management, Cristo Re Hospital, Rome, Italy
| | - D Sorbara
- Department of Health Management, S.M. Goretti Hospital, Latina, Italy
| | - P Benedetti
- Department of Health Management, Cristo Re Hospital, Rome, Italy
| | - D Grande
- Department of Health Management, Cristo Re Hospital, Rome, Italy
| | - C Brando
- Division of Internal Medicine and Gastroenterology, Cristo Re Hospital, Rome, Italy
| | - A D'Avino
- Division of Internal Medicine and Gastroenterology, Cristo Re Hospital, Rome, Italy
| | - S Parrocchia
- Department of Health Management, S.M. Goretti Hospital, Latina, Italy
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Giorgetti G, Fabiocchi F, D'Avino A, Tursi A, Brandimarte MA, Paoloni A, Meucci T, Parrocchia S, Brandimarte G, Nasi G. Assessment of the nutritional status in patients with acute diverticulitis. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The study evaluated the implementation of a screening strategy on all hospitalizations for diverticular disease (DD) of the colon with particular reference to acute diverticulitis (AD) regarding nutritional status.
Methods
The Nutritional Risk Security (NRS2002) system, was used, preselecting those with AD by the nurses of the nutrition team on the same day of admission from 1/01 to 31/12/2017 at the S. Eugenio Hospital in Rome. Patients (pts) with positive pre-screening were referred for additional evaluation performed by a dietician.
Results
AD was observed in 133 pts, 58% women, out of a total sample of 4667. The NRS2002 was applied to all, finding a positive screening test in 97 (72.9%) pts of whom a severely compromised nutritional status (NRS2002 score>3) in 61 pts (62.9%). Each patient tested positive was given initial nutritional support: oral supplements (17 pts, 17.52%), enteral nutrition (22 pts 22.68%), total parenteral nutrition (58 pts 59.8%). The mean length of hospital stay was 6.9 days, although was significantly longer for pts with NRS2002 positive (mean of 18 day). NRS2002 score can be a significant predictor of disease severity and outcome, operating independently of BMI, since a total score ≥3 can predict length of hospital stay.
Conclusions
The study confirmed that NRS2002 is a useful screening tool for identifying nutritional risk AD pts in hospital wards and allowed to select pts who needed a more careful monitoring program, diet therapy and possibly nutrition artificial. Furthermore, it showed an increasing and underestimated risk of malnutrition in a large number of pts hospitalized and that NRS2002 screening is a good predictor of some socio-health indicators such as hospital stay.
Key messages
There is an increasing and underestimated risk of malnutrition in a large number of patients hospitalized. NRS2002 is a useful screening tool for identifying nutritional risk and a good predictor of some socio-health indicators such as hospital stay.
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Affiliation(s)
- G Giorgetti
- Digestive Endoscopy and Nutrition Unit, S. Eugenio Hospital, Rome, Italy
| | - F Fabiocchi
- Digestive Endoscopy and Nutrition Unit, S. Eugenio Hospital, Rome, Italy
| | - A D'Avino
- Division of Internal Medicine and Gastroenterology, Cristo Re Hospital, Rome, Italy
| | - A Tursi
- Territorial Gastroenterology Service, ASL BAT, Andria (BT), Italy
| | | | - A Paoloni
- Division of Internal Medicine and Gastroenterology, Cristo Re Hospital, Rome, Italy
- Endocrinology and Diabetology Service, Cristo Re Hospital, Rome, Italy
| | - T Meucci
- Endocrinology and Diabetology Service, Cristo Re Hospital, Rome, Italy
| | - S Parrocchia
- Department of Health Management, S.M. Goretti Hospital, Latina, Italy
| | - G Brandimarte
- Division of Internal Medicine and Gastroenterology, Cristo Re Hospital, Rome, Italy
| | - G Nasi
- Department of Health Management, Cristo Re Hospital, Rome, Italy
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Nasi G, Parrocchia S, Mastromatteo AM, Triggiani A, Miraglia BA, Ferrazzani S, Moscato U, Metastasio P, Piscicelli C, Distefano FA. VBAC or not VBAC? Improvement of performance and outcome indexes with the promotion of care safety. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
In a multidisciplinary approach to Quality Management System and humanization of care, we aimed at evaluating the characteristics that influence the request of women to carry out Vaginal Birth after Cesarean (VBAC).
Methods
Skills have been improved, with the use of tests on dummies and case by case assessments. For the psychological-motivational study we have adopted: Informed consent, Semi-structured interview and Big Five Questionnaire. The women were recruited by both Gemelli and Cristo Re Hospital: the women following the counseling decided to undergo a second Caesarean Section (CS) (41, control group) and women who decided to complete a VBAC (22, experimental group).
Results
The analysis of the data shows that the women of the VBAC group are in the average between 31-35 years (57%), 80% has an education = or > at the 3rd level and the choice of the VBAC was conditioned by the partner (64%). The women of the control group are in average > 35 years (51%), 60% have a higher average education and the influence on the choice is oriented by the gynecologist/obstetrician (64%). From the personality test a statistically significant difference emerges between the dimensions Energy and Mental Opening. Past experience influences the choice of the next birth: women who are inclined to a second CS considered the previous CS as a positive event (66%) while only 36% in the VBAC group; 64% of this was the recovery of the painful post-surgery and a certain type of difficulty in the care of the child, in breastfeeding, of having suffered from post-partum mood alterations, which is why they chose to undertake a Trial of Labor After Cesarean.
Conclusions
The deeper knowledge of women as well as the preparation and safety of the same operators has shown that it is possible to perform a greater number of VBACs, with the sharing, participation and satisfaction of women and the entire team, leading to an improvement in outcomes and performance indexes.
Key messages
The promotion of care safety also improves the performance indexes through continuous training to the operators and the study of psychological aspects that lead to the choice to carry out a VBAC. Good Clinical Practice shown that it is possible to perform a greater number of VBACs, with the sharing, participation and satisfaction of women and the entire team.
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Affiliation(s)
- G Nasi
- Health Medical Direction, Cristo Re Hospital - GIOMI, Rome, Italy
| | - S Parrocchia
- Health Medical Direction, Santa Maria Goretti Hospital, Latina, Italy
| | - A M Mastromatteo
- Health Medical Direction, Cristo Re Hospital - GIOMI, Rome, Italy
| | - A Triggiani
- Division of Obstetrics and Gynecology, Cristo Re Hospital - GIOMI, Rome, Italy
| | - B A Miraglia
- Health Medical Direction, Cristo Re Hospital - GIOMI, Rome, Italy
| | - S Ferrazzani
- Division of Obstetrics and Gynecology, Fondazione Policlinico A. Gemelli - IRCCS Catholic University of Rome, Rome, Italy
| | - U Moscato
- Department of Public Health, Fondazione Policlinico A. Gemelli - IRCCS Catholic University of Rome, Rome, Italy
| | - P Metastasio
- Division of Obstetrics and Gynecology, Cristo Re Hospital - GIOMI, Rome, Italy
| | - C Piscicelli
- Division of Obstetrics and Gynecology, Cristo Re Hospital - GIOMI, Rome, Italy
| | - F A Distefano
- Division of Obstetrics and Gynecology, Cristo Re Hospital - GIOMI, Rome, Italy
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Petyx M, Parrocchia S, Gentiloni F, D'Alessandro D, Vescia N. [Mycotic pollution prevention in the indoor environments]. Ann Ig 1996; 8:305-15. [PMID: 8767972] [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: 02/02/2023]
Affiliation(s)
- M Petyx
- Ist. di Igiene G. Sanarelli, Università degli Studi di Roma La Sapienza
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