The patients' perspective: cut off points for satisfaction in pharmacological therapy and surgical outcomes.

Background: This article presents the results of a pilot study investigating patients' satisfaction thresholds for pharmacological outcomes versus surgical outcomes. Materials and methods.: A total of 150 participants were presented with two hypothetical scenarios depicting either pharmacological therapy or surgical interventions. Each scenario described a potential outcome, from a 10% clinical improvement (value 10) to a 100% clinical improvement (value 100) and asked participants to indicate the satisfactory level they would find acceptable. Conclusions: The results revealed distinct patterns in satisfaction thresholds between the two treatment modalities. Between the 150 participants, 52,7% were male and 47,3% female. We also identified a total of 28,8% whom were healthcare workers. Overall, the results for the pharmacological therapy outcomes observed a mean of 60,88 with a standard deviation of 22,77, a median of 60 and a mode of 70; while for the surgical outcomes the mean was 67,81 with a standard deviation of 23,03, the median 85 and the mode 80. We also observed that for the pharmacological therapy outcomes healthcare workers had a lower satisfactory cut off compared to non-healthcare workers. Another interesting finding was that for pharmacological therapy outcomes individuals under 50 y/o had a higher satisfactory cut off compared to individuals over 50 y/o, while for the surgical outcomes we got opposite results. Overall, the findings of this pilot study, even if limited, demonstrated higher minimum satisfaction expectations for surgical outcomes compared to pharmacological therapy outcomes. Specifically, participants tended to require more favorable results and outcomes from surgical interventions to meet their minimum satisfaction criteria.

Ultrashort pfas: a review of the topic.

Background: Ultrashort perfluoroalkyl substances (UsPFAS), characterized by carbon chain lengths of 2 to 4 atoms, represent a distinct subgroup within the broader PFAS class of chemicals. Despite their lower molecular weight, ultrashort PFAS have gained significant attention due to their widespread presence. This article provides a comprehensive review of the topic. Methods: We analyzed 33 articles published between 2017 and 2024 found on Pubmed using "ultrashort PFAS" as keyword. We compared: 1- environmental matrices in which ultrashort PFAS were found, 2- different distribution patterns, 3- degradation pathways, to better understand whether they may resemble longer-chain PFAS, which are known for their bioaccumulation and persistence as "forever chemicals". Conclusions: The occurrence of ultrashort PFAS has been documented in different environmental matrices (including surface waters, waste waters, precipitations, sediments, soils, and also human serum and urine) indicating widespread environmental exposure. Advanced analytical techniques, such as liquid chromatography-tandem mass spectrometry (LC-MS/MS) and gas chromatography-mass spectrometry (GC-MS), have enabled the sensitive detection and quantification of these compounds at trace levels. Studies keep finding new ultrashort PFAS and have focused on elucidating their sources and fate pathways to better understand their behavior in natural systems. The toxicity of ultrashort PFAS remains an area of active in-vestigation. While less is known about their health effects, studies suggest potential adverse impacts on organisms and ecosystems. This underscores the importance of continued research to assess the eco-logical consequences of ultrashort PFAS exposure and bring up risk management strategies.

Alleged malpractice in orthopaedics. Analysis of a series of medmal insurance claims.

BACKGROUND: Medical malpractice is an important topic worldwide, and orthopedics is a clinical branch that is considered to be at a high risk for claims. The analysis of a series of medmal insurance claims allows forensic pathologists, clinicians, and insurance companies to probe the risk of a specific clinical branch for medical malpractice claims and highlights areas where care may be improved. We investigated the main features of a major Italian insurance broker's archive in order to identify recurrent pitfalls in this field. MATERIALS AND METHODS: A retrospective study was carried out on orthopedics claims. The archive covered claims from 2002 to 2013 that targeted 1980 orthopedists. RESULTS: 635 claims were found and analyzed with a focus on the clinical activity invocked in the claim, the presence of alleged team malpractice, the clinical outcome of the case, and the final forensic decision regarding the claim. 299 orthopedists had at least one malpractice claim made against them during the available period; 146 orthopedists were subject to more than one malpractice claim. Most of the claims regarded perioperative and operative cases, usually originating from civil litigation. The anatomical sites most commonly involved were the hip or knees, and sciatic nerve lesions were the main contributor. CONCLUSIONS: Orthopedics is a medical specialty with a high risk for malpractice claims. In our study, medical malpractice was observed in nearly 50% of the cases-typically in surgery-linked cases resulting in permanent impairment of the patient. Death from orthopedics malpractice seemed to be rare. LEVEL OF EVIDENCE: IV.