Workplace violence against healthcare workers: an umbrella review of systematic reviews and meta-analyses.

OBJECTIVES: The aim of this umbrella review of systematic reviews and meta-analyses was to address workplace violence (WPV) against healthcare workers (HCWs). Several systematic reviews exist in the literature, but the diversity of settings, population considered, and type of violence investigated make it difficult to gain insight and use the vast amount of available data to implement policies to tackle WPV. With this in mind, we conducted an umbrella review of systematic reviews and meta-analyses on WPV against HCWs to examine the global prevalence of the phenomena and its features. STUDY DESIGN AND METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, PubMed, Scopus, and ISI Web of Science were searched for relevant systematic reviews and meta-analyses published in English up to November 2022. Data on authors, year, country, violence type, prevalence (pooled and not), setting, population, and specific considerations were extracted. RESULTS: A total of 32 systematic reviews were included, 19 of which performed a meta-analysis, investigating overall, physical, and non-physical violence. Even considering the variability of the data, the COVID-19 pandemic has exacerbated the scale of the problem. From our review, we found that overall violence prevalence among HCWs was reported to be as high as 78.9%, and nurses working in psychiatric wards were the professionals most impacted. CONCLUSION: In conclusion, this umbrella review revealed a high prevalence of WPV among HCWs, which varies between countries, population subgroups, and detection methods. Strengthening recognition of the problem could lead to appropriate local and international strategies to address it.

An overview of Personalized Medicine landscape and policies in the European Union.

BACKGROUND: The spread of Personalized Medicine (PM) over the last decade defined a revolution in healthcare systems. PM is among the priorities of the European Commission's research agenda, which funded the IC2PerMed international project aiming to integrate China into the International Consortium of PM (ICPerMed). In the context of this project, we mapped the existing policies related to PM in the European Union (EU) and at the EU Member States (EU-MS) level. METHODS: PubMed, Google Scholar, Google, Microsoft and national and international institutions' official repositories were searched in order to identify documents on PM-related policies, programmes and action plans at the EU and EU-MS level, published up to December 2020. RESULTS: We identified 28 policies in the EU aimed at improving public health promoting and fostering PM implementation, through some actions including the standardization of good medical practice, use of big data and digital innovation, data sharing and cross-border interoperability, healthcare sustainability, disease prevention and patients'/citizens' engagement. We identified 23 policies at EU-MS level which, notwithstanding national differences, have a common focus, such as patient-tailored treatment and targeted prevention, education of healthcare workers, research and innovation, big data harmonization and healthcare system sustainability. CONCLUSIONS: The definition of an integrated regulatory framework is essential to turn PM into an opportunity for citizens and patients with the involvement of all the stakeholders. This work can provide a valuable tool for decision-makers to define common approaches, priorities for research, development and increase international collaboration, which could overcome the fragmented European scenario and align the future direction on PM.

The brain amino acid pattern in experimental coma due to phenytoin in guinea pigs.

An experimental study was carried out on 50 guinea pigs to evaluate the amino acid pattern in the whole brain after a toxic dose of phenytoin (1 g . kg-1 body wt). One group of 25 guinea pigs was treated with the drug which made them comatose, and their brains removed by craniotomy and frozen in liquid nitrogen; 25 guinea pigs were used as a control group. The brain amino acid pattern was determined by ion-exchange chromatography. All the amino acids, except threonine and methionine, decreased. Hypotheses about the particular cerebral metabolic pathways involved are discussed.

The effect of five drugs in coma doses on neurotransmitter amino acids in the brains of guinea pigs.

The study has been carried out in order to investigate the effects of some drugs in coma doses on the concentration in brain of some amino acids involved in brain function. Six groups of 25 guinea pigs each were utilized. In each of the five groups a subcutaneous dose of diazepam, flunitrazepam, phenobarbital, phenytoin or alfaxalone, was injected and one group was utilized as control. Some neurotransmitter amino acids (glutamate, aspartate, glycine and taurine) and precursors of neurotransmitters (phenylalanine and tyrosine) were determined in brain preparations. The results are discussed.

[Anesthesiological problems in tracheal resection operations. Clinical contribution]. / Problemi anestesiologici negli interventi di resezione tracheale. Contributo clinico.

The anaesthesia technique adopted for tracheal resection in a woman patient with tracheal stenosis secondary to prolonged intubation is reported. The criteria underlying the choice of anaesthesia are outlined. Various anaesthesiological techniques are discussed and solutions illustrated in relation to the location of tracheal stenosis.

[Our experience with peridural anesthesia in labor]. / Nostra esperienza sulla anestesia peridurale in travaglio di parto.

A clinical study has been carried out on 86 child-bearing mothers, continuous lumbar peridural block being employed, in the light of personal experience, to induce analgesia during labour. The results were positive on the whole as regards duration and the algogenous intensity measured during the dilatation phase and during expulsion.

[Peridural anesthesia and adrenocortical function in man]. / Anestesia peridurale nell'uomo e funzione corticosurrenale.

A brief account of the stress action of anaesthetic drugs is followed by the description of an evaluation of plasma cortisol concentration in an enquiry into the effects of peridural anaesthesia with bupivacaine.

[Effects of CT 1341 (althesin) anesthesia on human adrenal cortical function]. / Effetti dell'anestesia con CT 1341 (althesin) sulla funzione corticosurrenalica nell'uomo.

Following a short introduction on the stress action of anaesthetics, the effects of anaesthesia with CT 1341 (Althesin) on cortico-adrenal function was investigated, with an evaluation of cortisone plasma concentration. The results obtained in 10 patients point to an increase in plasma cortisone after 30 and 150 minutes of anaesthesia. The discussion hypothesizes the possible influences of the anaesthetic on the hypophyseal-adrenal axis.

[Lumbar epidural anesthesia in peripheral arteriography]. / L'anestesia peridurale lombare nelle arteriografie periferiche.

A brief survey of the difficulties associated with the intra-arterial administration of contrast media during peripheral arteriography is followed by an assessment of anaesthesiological and arteriographic results obtained with lumbar peridural anaesthesia in a group of patients. Complete analgesia, block of the sympathic, and motor block gave particular assistance in the securing of optimum definition of the radiographical picture of the peripheral circulation. These and other advantages offered by peridural anaesthesia suggest that it is a valid technique for peripheral arteriography.

[Cardiac contusion in closed injuries of the thorax]. / La contusione cardiaca nei traumi chiusi del torace.

Cardiac contusion is a fairly frequent clinical event in closed chest traumas. The diagnostic problems it involves influence prognosis in these patients and, in effect, prevention, speedy recognition and early treatment of the complications of cardiac contusion are essential for therapy. Here the incidence of cardiac contusion in a group of patients with closed chest trauma is analysed and the clinical, diagnostic and therapeutic aspects are examined.

[Gaseous myelography. Accidents and complications. Case reports]. / Mielografia gassosa. Incidenti e complicanze. Contributo clinico.

Attention is called to the risks of gas myelography and two cases of complications are described. One of these, observed personally, was fatal and its possible pathogenetic mechanisms are illustrated. Stress is laid on certain rules and precautions that should be respected in radiological and anaesthesiological practice. Insufflation pressure and volumes of injected air deserve particular attention and scrupulous intraoperative control cut of vital parameters must be carried and appropriate attention paid to patient hydration during the postoperative period.