ABSTRACT
Psoriasis is a chronic inflammatory, immune-mediated skin disorder that affects 1.5-1.8 million people in Italy. The most common form of the disease is chronic plaque psoriasis, affecting about 90% of psoriasis patients, with about 20%-30% of them suffering from a moderate or severe condition. Little information is available about the economic impact of psoriasis in European countries. The primary objective of this study was to perform a cost-of-illness analysis of patients with moderate and severe plaque psoriasis in Italy. Therefore, direct, indirect costs, and intangible costs (quality of life - QoL) were assessed. In this national, multicenter, prospective, 3-month cost-of-illness study of moderate and severe plaque psoriasis, direct and indirect costs were assessed from the patient, third-party payer (National Health Service, NHS), and societal perspectives. From November 2003 to October 2004 consecutive patients were enrolled over a 1-year period, in order to minimize seasonal fluctuations in disease severity. 150 patients enrolled in 6 investigational sites in Italy, completed the study, and were eligible to be analyzed according to the study protocol. Intangible costs (QoL) were measured using SF36 and DLQI questionnaires. The mean total cost for psoriasis (average Psoriasis Area Severity Index [PASI] score 21.4), including direct and indirect items, was euro8,371.61 per patient per year. The mean cost for patients with moderate disease (PASI 20) was euro11,434.40 per year. Disease heavily affected QoL measured using SF36, and the impairment was greater in patients affected by a more severe form of disease. Moderate and severe plaque psoriasis is associated with extremely high costs, which are related to disease severity. Data from this study show that the more severe plaque psoriasis, the higher the direct and indirect costs for its management. Direct costs are higher than indirect costs; hospitalization represents the most significant item, accounting for 30% of the total expenses. QoL in moderate and severe plaque psoriasis is low compared with the population at large, confirming the high impact of plaque psoriasis on QoL. The relatively high average annual costs per patient point to the need for a more efficient and long-term control of psoriasis.
ABSTRACT
The application of technology in the production, processing, preservation and transport of food has led to a well known consequence: the presence in the foods of undesirable substances and chemicals, that is to say "the contaminants of feeding". In this study the authors report the main groups of contaminants as the mycotoxins, nitrates, pesticides, methylmercury, lead, cadmium etc., relating for everyone of them the harmful effects for the health of human being, of which they have come to know mostly for some episodes of acute poisoning occurred in several countries in the world. They relate also the hypothetical effects of a chronic exposure to low levels of contamination, mostly if the fetuses and infants come to be exposed to these contaminants for the peculiar embryo genetic and evolutive situation that characterizes them.
Subject(s)
Food Contamination , Pediatrics , Child , HumansABSTRACT
The identification of organic substances present in mineral water has engaged the interest of hydrologists since the last century. Nowadays these organic substances, even if present in very small quantities, can usually be identified thanks to the remarkable progress made in various techniques of isolation, resolution, identification and dosage. The authors report the results achieved using a methodology of concentration by means of active coals and identification with thin-layer chromatography.
