[From research to medical advice: prescription of physical activity to 1,005 subjects with type 2 diabetes mellitus by 48 family doctors. Results]. / Dalla ricerca alla pratica medica: prescrizione di attività motoria a 1.005 soggetti con diabete mellito di tipo 2 da parte di 48 medici di famiglia. Risultati.

OBJECTIVES: to involve a group of general practitioners (GPs) in a programme for prescribing physical activity (PhA) for patients with type 2 diabetes; to document, for each patient, the amount of physical activity carried out and the modifications in biomedical variables and in the medical expenses possibly occurring after the PhA programme. SETTING AND PARTICIPANTS: 48 GPs joined the project. The beneficial effects of regular PhA on diabetes were presented to each patient enrolled. Walking daily for at least 15 minutes was suggested. A booklet with specific instructions and a step meter were given to each patient. Diet programmes were not modified. MAIN OUTCOME MEASURES: average daily PhA; values of Body Mass Index (BMI), waist circumference, systolic and diastolic blood pressure, blood glucose and HbA1c, blood cholesterol (total, LDL, HDL) and triglycerides determined before and at the end of the programme; pharmaceutical expenses attributed to the enrolled patients in 2008 (the year preceding the PhA programme) and in 2010 (the year of end of the PhA programme). RESULTS: of the 1,005 patients enrolled, 766 indicated their daily PhA. In all patients, and especially in those who presented values outside the norm in the variables considered at the start of the programme, improvements up to normalization were observed. A reduction in pharmaceutical expenses proportional to the PhA carried out was documented in the more active group of patients, who walked 1 km or more daily. CONCLUSIONS: the domiciliary PhA recommended by 48 GPs for 1,005 patients with type 2 diabetes enrolled in the programme was carried out by 766 subjects. The biomedical improvements and the reduction in pharmaceutical expenses, proportional to the PhA carried out, are in keeping with other reports in the literature. The major finding of this project is that GPs can effectively prescribe PhA to their patients who suffer form sport-sensitive diseases, such as type 2 diabetes.

[Travellers' compliance with the use of an oral cholera vaccine]. / Compliance all'utilizzo di un vaccino orale contro il colera in viaggiatori.

A questionnaire study was performed amongst subjects travelling to high-risk areas for traveller's diarrhoea and who had been prescribed the oral cholera vaccine Dukoral. The study was performed in 2006 at two travel medicine centres in northern Italy. One-hundred subjects participated in the study and completed the questionnaire. Compliance with the vaccine was very good (83.2%) and no serious adverse reactions were reported. 14.3% of vaccinated subjects reported diarrhoea.

The control of asthma in Italy. A multicentre descriptive study on young adults with doctor diagnosed current asthma.

BACKGROUND: Few data are available on the management of asthma in the general population. The aim of this study was to evaluate the level of asthma control in Italian patients, a decade after the publication of the international guidelines. MATERIALS AND METHODS: Within the framework of a multicentre, population-based study on people aged 20-44 years, 18 873 subjects replied to a postal screening questionnaire (response rate = 72.7%) on the presence of asthma symptoms and exacerbations, and their impact on daily life. All subjects reporting having ever had a doctor diagnosis of asthma and either taking medicine for asthma when interviewed or having had an asthma attack in the last 12 months, were considered current asthmatics. RESULTS: Of the screened subjects, 649 (3.4%) were current asthmatics. Of these, only 14% did not report exacerbations or had been symptom-free in the last 12 months. More than 20% of current asthmatics had their daily life activities seriously impaired and 54 patients (8%) had at least one hospital/emergency department admission as a result of asthma exacerbation in the last 12 months. The life impairment and the rates of hospitalization significantly increased as the control of the symptoms worsened. The use of asthma drugs was quite common in current asthmatics: 586 (90.2%) reported having been under pharmacological treatment in the last 12 months. Only 63 patients (10%) had the disease under control (neither symptoms nor life impairment): they had a significantly higher percentage of drug use (100%vs 89%) and of daily use prescriptions (50%vs 36%) than non/moderately controlled asthmatics. Poorly controlled asthmatics had a significantly higher percentage of women (63%vs 44%), of patients with the coexistence of chronic cough and phlegm (47%vs 30%) than moderately/well-controlled asthmatics. The comparison between our data and similar data collected in 1991 in Italy showed that the use of asthma drugs increased by about 12%, while the control of symptoms did not improve in the last decade. CONCLUSION: Despite the high percentage of drug users, the control of symptoms and exacerbations was overall poor in Italy and resulted in a heavy individual and social burden, pointing out that the guideline goals have far from been reached in Italy.