Medicine In Italy Research Articles

Inadvertent oral administration of methylergometrine maleate to children in the first months of life: from surveillance to prevention.

Methylergometrine maleate is an ergot alkaloid frequently used in obstetrics for prevention and treatment of post partum haemorrhage. Accidental administration of this medicine to newborns can cause severe effects and should be carefully prevented. The present paper is aimed at describing the main characteristics of cases accidentally exposed to this medicine in Italy before and after Novartis, the manufacturer of Methergin®, a widely used methylergometrine maleate-containing gynecological medication, decided to withdraw the drop preparation from the European market. The study design is a case-series study. The database of the National Poison Control Centre of Milan was searched retrospectively (from 1 January 2005 to 31 December 2011) and prospectively (from 1 January 2012 to 31 December 2013) in order to provide a descriptive analysis of the main characteristics of cases unintentionally exposed to methylergometrine maleate and to document the impact of Novartis' decision. In the first period under study (2005-2011), a total of 642 cases of exposure to methylergometrine maleate were identified. Most of them were children aged <1 year (No. 483, 75%). Patients aged 1-2 and 3-5 years accounted for 13% (No. 85) and 9% (No. 56) of cases, respectively. Among children aged <1 year, about 76% (No. 368) were exposed during the first month of life, including 44% (No. 211) of cases exposed in the first week of life. The main cause of exposure was medication error (No. 432, 89%), mainly due to oral administration of methyltergometrine maleate in place of a paediatric preparation (No. 469, 97%). About 14% of these cases suffered clinical effects as a consequence of the exposure. Severity of poisoning was minor in 45 cases, moderate in 12, and severe in one case. The main cause of exposure among children aged 1-2 and 3-5 years was uncontrolled access to the medicine, accounting for 78% (No. 66) and 77% (No. 43) of cases, respectively. Some 9% (No. 8) of cases aged 1-2 years and 7% (No. 4) of those aged 3-5 years developed signs/symptoms possibly related to the exposure. For all of them, severity of clinical effects was low, but one case suffered moderate effects. Exposure to the medicine in drops was reported for 87% (No. 74) and 84% (No. 47) of cases aged 1-2 and 3-5 years, respectively. In 2012-2013 a total of 25 cases were observed. Among them, two patients were aged <1 year (8%). Both cases occurred in 2012 and were inadvertently administered the medicine in drops still available (present) in the home. Fourteen (56%) and 8 (32%) cases were aged 1-2 and 3-5 years, respectively. All of them were exposed to the tablet formulation following uncontrolled access to the medicine. The observations here reported indicate that having different formulations for methylergometrine maleate-containing products intended for the mother and paediatric medicines can successfully prevent medication error due to medicine exchange in the first months of life.

Professionalization of anesthesiologists and critical care specialists in humanitarian action: a nationwide poll among italian residents.

Over the last decades, humanitarian crises have seen a sharp upward trend. Regrettably, physicians involved in humanitarian action have often demonstrated incomplete preparation for these compelling events which have proved to be quite different from their daily work. Responders to these crises have included an unpredictable mix of beginner-level, mid-level, and expert-level providers. The quality of care has varied considerably. The international humanitarian community, in responding to international calls for improved accountability, transparency, coordination, and a registry of professionalized international responders, has recently launched a call for further professionalization within the humanitarian assistance sector, especially among academic-affiliated education and training programs. As anesthetists have been involved traditionally in medical relief operations, and recent disasters have seen a massive engagement of young physicians, the authors conducted, as a first step, a poll among residents in Anesthesia and Critical Care Medicine in Italy to evaluate their interest in participating in competency-based humanitarian assistance education and in training incorporated early in residencies. The Directors of all the 39 accredited anesthesia/critical care training programs in Italy were contacted and asked to submit a questionnaire to their residents regarding the objectives of the poll study. After acceptance to participate, residents were enrolled and asked to complete a web-based poll. A total of 29 (74%) of the initial training programs participated in the poll. Out of the 1,362 questionnaires mailed to residents, 924 (68%) were fully completed and returned. Only 63(6.8%) of the respondents voiced prior participation in humanitarian missions, but up to 690 (74.7%) stated they were interested in participating in future humanitarian deployments during their residency that carried over into their professional careers. Countrywide, 896 (97%) favored prior preparation for residents before participating in humanitarian missions, while the need for a specific, formal, professionalization process of the entire humanitarian aid sector was supported by 889 (96.2%). In Italy, the majority of anesthesia/critical care residents, through a formal poll study, affirmed interest in participating in humanitarian assistance missions and believe that further professionalization within the humanitarian aid sector is required. These results have implications for residency training programs worldwide.

Census of Ligurian Internal Medicine Wards of non-teaching hospitals

What is the future of internal medicine in Italy? Which competencies? Which potentialities? To this aim Ligurian FADOI Regional Society performed a census among 18 Internal Medicine Wards (IMWs) in non-teaching Ligurian Hospital. We administered, by email, a questionnaire to the heads of IMWs. Data about staffing, equipment, skills, competencies and productivity during 2011 were collected from 1 st to 31 st November 2012. A total of 15/18 (83.3%) chiefs answered to the questionnaire. The number of beds was largely variable among the wards. In 2011, mean diagnosis-related group (DRG)-weight was 1.09 (range 0.91-1.6) and that revenues/costs ratio much higher than 1.5. Staff was quite adequate to standards defined by current law, only 33% has got a doctor:patients ratio superior to 1:6.4. However, annual hospitalizations exceed the availability of beds in medicine and the complexity of the patients would require a lower doctor:patients ratio, at least for a group of patients. In fact, 4 wards have a progressive care organization with a defined area for more seriously ill patients. Mean length of stay was 10 days. Expertise was wide, covering almost all medical sub-specialties. Acquired skills such as abdominal, heart and vascular ultrasounds, invasive procedures and their comprehensive knowledge make internists complete and cost-effective specialists. IMWs, as a concentrate of medical knowledge and skills, are the natural destination of current patients with co-morbidities. Staffing and number of beds should be revised according to this new demand. Their revenues/costs ratio resulted favorable and their global approach to patients and not to disease can be useful for resource rationalization. Wider and further studies are needed to improve the awareness of stakeholders about Internal Medicine.

ELAG - 10 Successful Years.

Few initiatives in Latin America last 10 years, and when they do, we should not only celebrate but also try to understand why and how the initiative survived. Since he attended the 1991 the European School of Genetic Medicine in Italy, Roberto Giugliani had the desire to create a Latin American School of Genetics, an initiative that was inspired by the annual Bar Harbor Course in “Mammalian Genetics” in Maine, USA. To bring his idea to life, he enthusiastically sent many of his collaborators to take the same course over the years. When we first met in 1994, as an undergraduate student and supervisor, he had “Latin American School of Medical Genetics” on a note entitled “ideas for the future” that was posted on the front of his desk. When the Latin American Network of Human Genetics (RELAGH) was created in 2001, the Latin American School of Genetics was proposed as an initiative of RELAGH, with strong support from Jose Maria Cantu, the first President of RELAGH. When Roberto Giugliani became RELAGH President in 2003, he prioritized the organization of the Latin American School. In 2004, ten years after the “ideas for the future” note, we organized the first Latin American School of Human and Medical Genetics. The school initially dropped “Medical” from its acronym to be known as LASHG (English) or ELAGH (Spanish/Portuguese) and then later dropped “Human” to finally become ELAG, as it is known today all over Latin America. The original idea of bringing high-profile scientists in the fields of human and medical genetics together to spend a week with selected students from all over the continent in a friendly environment to foster communication, discussion, and the exchange of knowledge and experiences was never lost. This successful formula was common to both courses that inspired ELAG and has captivated a group of faculty members who contribute to the event every year. We should note that in 2004 we did have to take some risks, as we hoped to have enough applicants and financial resources to support the first edition of the school, scheduled to take place in May 2005. At that point, as it has been throughout the years, support from the scientific committee (composed of outstanding Latin American scientists and good friends) was decisive and set forth the initiative. To this day, the original scientific committee (Eduardo Castilla, Francisco Salzano, Victor Penchaszadeh, and the authors) remains almost unchanged, with the exceptions of Sergio Pena and Gerardo Jimenez-Sanchez, who stepped down due to other commitments, and the early loss of Jose Maria Cantu, who was replaced by Augusto-Rojas Martinez. Additionally, support from both national and international public funding agencies and from private companies (mainly of the biotechnology field) was instrumental in providing selected students with fellowships covering most of the costs of the course. Such support has allowed the participation of young scientists and health professionals even when economic conditions have been unfavorable. Now, ten years later, we are proud that the school has been held without interruption year after year, providing a unique educational experience to over 700 students from almost all of the Latin American countries. To celebrate this achievement, ELAG is sponsoring this special edition of Genetics and Molecular Biology that includes contributions from ELAG faculty members who have held distinguished roles during the school’s many editions. Here, the reader will find a wide range of papers that record some important chapters of genetics in Latin America and provide a wide range of reviews on selected topics, reflecting the comprehensive nature of ELAG’s program, including human evolution, medical population genetics, molecular biology, genetics of birth defects, molecular cytogenetics, cancer genetics, genetic counseling, and gene therapy. The joyful and nostalgic feelings experienced at the school’s conclusion each year reflects the success of this experience and provides us with the energy to organize ten more courses!

Information and Communication Technology in medicine in Italy: problems and perspectives. A document by the "e-cardio" area of the Italian Association of Hospital Cardiologists (ANMCO)

In Italy, health protection is an individual right protected by the article 32 of the Constitution, granted to everyone since 1978 by the foundation of the National Health Service. However, regionalization of the healthcare system has caused noticeable discrepancies among the different areas of the country. The use of the Information and Communication Technology (ICT) may be useful to solve them. The purpose of this document is to analyze the implementation of ICT in Italy, on the basis of the suggestions given by the Italian Association of Hospital Cardiologists (ANMCO). In 2010, the Italian government introduced the electronic health record (EHR), which includes a minimum core of essential documents that should be created and updated by general practitioners. The obvious limitations of this methodology become clear in the urgency-emergency clinical setting, where the availability of particular clinical data may influence both patient prognosis and cost reduction. Also the privacy rules, currently very restrictive, cause a drawback in reliability of the data reported in the EHR, thus arising the need for a balance shift from privacy to health rights at the level of both the individual and the community. A minimum core of mandatory clinical data to be included in the EHR should be defined. No formal indications for filling out the medical records are available and most few experiences concern "bureaucratic documents" on the diagnostic and therapeutic process. Conversely, we believe that medical records should become a diagnostic and therapeutic tool that makes health rights uniform across the country. Each medical record form should include the following features: a simple interface, a mandatory association of clinical findings and reports, data portability and accessibility, and adherence of the information to a minimal dataset. Additionally, medical records data should merge into a modified EHR available at any time and place through network access points with adequate connection speed. In this respect, inhomogeneous availability of broadband in Italy is at present a major challenging issue. Finally, current training programs in medicine do not allow for widespread application of ICT among young physicians. Some essential topics should be covered by university formative credits. It is crucial to address different needs: the patient needs, making data on "biological heritage" always available; the physician needs, providing them with professional tools able to improve their daily quality of work; the managers' and public decision makers' needs, helping to optimize costs of the healthcare system.

PHP97 - Analysis of Spanish Generic Medicines Market: Recommendations to Enhance Long-Term Sustainability

Italy is among the European countries with the lowest uptake of generic medicines. This paper provides a perspective on the Italian generic medicines retail market. Fast market entrance of generic medicines in Italy is hindered by several factors: the existence of Complementary Protection Certificates in the past, the large market for copies and multiple cases of patent linkage. Prices of generic medicines in Italy are low compared to other European countries. To contain pharmaceutical expenditure, pharmaceutical companies are currently forced to pay back in case of overspending, which disproportionally penalizes small and fast growing companies, to which most generic companies belong to. Current demand-side policies do not successfully stimulate the use of generic medicines. The current market environment surrounding the Italian generic medicines retail market (i.e., low prices, low volumes) threatens its long-term sustainability. Recommendations to enhance the long-term sustainability of the Italian generic medicines retail market round off this perspective paper.

Organization of Physical and Rehabilitation Medicine in Italy: New Ways Toward Developing Our Specialty

Organization of Physical and Rehabilitation Medicine in Italy: New Ways Toward Developing Our Specialty

Education in traditional acupuncture in Italy: The oldest Italian private school of acupuncture adopts WHO guidelines

Times are changing in Italian healthcare and Traditional and Non Conventional Medicine has become increasingly relevant to medical practice. With this comes an increasing need for guidelines. As the use of Traditional and Non Conventional Medicine has increased in Italy, so has the need for high standards in education in this field (outside of biomedicine and the dominant health system) among medical students, medical doctors and medical educators. The rise of Traditional and Non Conventional Medicine is so relevant for medical practice and health care in Italy; the time calls for a change. The article describes this new setting in regards to education in Acupuncture within the field of Traditional Chinese Medicine in Italy's oldest private school.

The Progress of Perinatal Medicine in Italy

Perinatal drugs in Italian Republic became a national entity with the inspiration in Rome in 1984 of the Italian Society of perinatal drugs. Some pioneering works from late 60s are done antecedently primarily by teams of investigators based mostly at the colleges of Parma (Bruno Salvadori), Florence (Corrado Vecchi) and Rome (Emilio Imparato), followed within the 70s by teams in Modena (Giorgio Montanari), Rome (Antonio Pachi’, Ermelando Cosmi, Giovanni Bucci) Milano (Giorgio Pardi), and others. it’s through the inspiration and implementation of the Italian Society that the event of perinatal drugs in Italian Republic has taken a giant breakthrough. above all, the Society created 2 sets of tips on the “Organisation and management of perinatal medicine” that marked the organisation, blending and advancement of perinatal centers in Italian Republic, and therefore the systematic audit of perinatal drugs statistics transfer Italian Republic among the countries within the world that have the simplest perinatal organisation, and therefore the best perinatal statistics in term of maternal and fetal-neonatal mortality and morbidity.

Update on Rehabilitation Medicine in Italy

Update on Rehabilitation Medicine in Italy

The use of telemedicine in Italian Blood Banks: a nationwide survey.

Telemedicine is defined as the use of electronic information and communication technologies to provide health care between distant people. Many activities in transfusion medicine could benefit from the application of telemedicine. To map the spread of the use of telemedicine in transfusion medicine in Italy, the Italian Society of Transfusion Medicine and Immunohaematology (SIMTI) performed a nationwide survey: the results are presented in this paper. A survey, dealing with different aspects of the use of telemedicine, was performed by sending a questionnaire to 280 Italian Blood Centres. The survey was designed to evaluate the diffusion of telemedicine and the features of the systems, with special attention to the systems' safety and legal adequacy. One section of the questionnaire was designed to identify the features of the systems considered essential by the respondents. Out of 280 Blood Services contacted, 196 (70%) filled in at least one of the questions of the online questionnaire. Globally the use of some form of telemedicine was reported by 70% of the respondents. Telemedicine is used for remote validation of laboratory tests by 32% of the Centres that responded, for remote biological validation of blood units by 34% and for assignment of blood components by 29%. Less frequently, telemedicine is used to control electronic refrigerators, for electronic blood requests and for bed-side identification of patients. The use of telemedicine is widespread in Italian Blood Services. There appears to be some heterogeneity between structures with regards to the evaluation of the systems' safety and their legal adequacy. No telemedicine system should be introduced into practice until it has proven to have the same standards of safety as the corresponding "on site" activity.

Traditional and unconventional medicine in Italy: reflections upon a social choice for person-centred medicine

Traditional and unconventional medicine in Italy: reflections upon a social choice for person-centred medicine

Osteopathic medicine in Italy: a descriptive study

Osteopathic medicine in Italy: a descriptive study

Traditional Chinese medicine in Italy: a hospital experience in Turin

Traditional Chinese medicine in Italy: a hospital experience in Turin

Russia and Early Modern European Medicine

Russia and Early Modern European Medicine Clare Griffin (bio) Sandra Cavallo and David Gentilcore, eds., Spaces, Objects, and Identities in Early Modern Italian Medicine. 136 pp. Oxford: Blackwell, 2008. ISBN 1405180404. $34.95. Sabine Dumschat, Ausländische Mediziner im Moskauer Russland (Foreign Doctors in Muscovite Russia). 750 pp. Stuttgart: Franz Steiner, 2006. ISBN 3515085122. €88.00. Aleksandra Borisovna Ippolitova, Russkie rukopisnye travniki XVII–XVIII vekov: Issledovanie fol′klora i etnobotaniki (Russian Manuscript Herbals of the 17th and 18th Centuries: An Investigation of Folklore and Ethnobotany). 511 pp. Moscow: Indrik, 2008. ISBN-13 978-5857594650. David Lederer, Madness, Religion, and the State in Early Modern Europe: A Bavarian Beacon. 383 pp. Cambridge: Cambridge University Press, 2006. ISBN 0521853478. $52.00. Russian courtly medicine of the pre-Petrine period was heavily influenced by European trends. It was practiced by Western graduates of prestigious universities, who brought the ideas they had learned at these institutions with them to Russia. A sizable proportion of the medical preparations used by the Russian court also came from Western Europe. On the one hand, Russia was a part of the European medical world. On the other, Muscovy lacked a number of central features of that world: there were no universities, [End Page 967] no surgeons’ guilds or medical colleges, and no private apothecary shops before the 18th century. Muscovy’s ambiguous status vis-à-vis the European medical world may explain the fact that the historiography of Muscovy and that of early modern European medicine rarely overlap. Here I reassess this historical and historiographical divide. Based on the books under review, this essay seeks to demonstrate that, despite the differences between Europe and Muscovy, approaches and methods developed during the investigation of the former can fruitfully be applied to the latter. One aspect of medicine in Muscovy that has attracted much scholarly attention is the role of medical practitioners at the Russian court. Sabine Dumschat’s work on foreign physicians’ occupational and social activities in Moscow belongs to this tradition. A volume of articles edited by Sandra Cavallo and David Gentilcore on medicine in Italy offers a useful comparison, since it too deals with physicians’ occupational and social activities. Moreover, it presents both new approaches and nonstandard sources for the study of medicine—court proceedings and canonization hearings rather than medical records—suggesting directions of development for the history of Muscovy. David Lederer’s work on state-sponsored spiritual healing in Bavaria is also helpful, as it raises the issue of the relationship between religious and secular healers. These works allow us to address questions about the status of foreign medical practitioners and the forms and institutions of professional medical practice in various societies, including Muscovy, during the early modern period. A second area of focus for this review is the history of ideas. Lederer’s work is important in this regard too, as he devotes much space to the classification of mental disorders. His approach invites interesting comparisons with Aleksandra Ippolitova’s classification of illnesses in her study of herbals. These two works allow us to look at how European ideas interacted with Russian beliefs, both secular and religious. Sabine Dumschat’s doctoral dissertation, Ausländische Mediziner im Moskauer Russland, written at Universität Hamburg, looks at the activities and experiences of foreign physicians employed in the Aptekarskii prikaz (Apothecary Chancery). The chancery came into being at some point in the late 16th century, although the surviving records cover the period 1629–1713. During this period a number of medical practitioners came to Russia from across Europe, including surgeons, distillers, apothecaries, and physicians. Dumschat’s work is by no means the first to exploit the chancery records as a source base. An initial publication of the documents appeared in the 1880s (although unfortunately it is now a bibliographical rarity).1 Since then, a number of scholars have published studies focusing on this institution [End Page 968] and its employees.2 Dumschat’s work appears less than a decade after the publication of Maria Unkovskaya’s collective biography of the Apothecary Chancery’s medical staff.3 Dumschat’s central question is what role foreign physicians played in Muscovite culture. She frames this question as a reaction to a...

The need for higher education in the sociology of traditional and non-conventional medicine in Italy: towards a person-centered medicine

Italy is being forced to re-think her health plan as the national health service moves towards regional systems, individuals take more active responsibility for their health, the demand grows for traditional and non-conventional medicine and immigrants join the user list. Person-centered medicine and ever-wider skills attainable with the tools of analysis and research have made a new professional update indispensable. The proposed Master-Course on “Health systems, traditional and non-conventional medicine”, first of its kind in Italy, fits this bill. The new forms of treatment that state and international bodies are prepared to recognize depend entirely on the universities training our professionals with concrete skills in planning, research and health management. Our paper performs an epistemological critique of the new health requirements and goes on to outline the reasons behind this training imperative.

Randomized Clinical Trial on Ivermectin versus Thiabendazole for the Treatment of Strongyloidiasis

BackgroundStrongyloidiasis may cause a life-threatening disease in immunosuppressed patients. This can only be prevented by effective cure of chronic infections. Direct parasitologic exams are not sensitive enough to prove cure if negative. We used an indirect immune fluorescent antibody test (IFAT) along with direct methods for patient inclusion and efficacy assessment.Methodology/Principal FindingsProspective, randomized, open label, phase III trial conducted at the Centre for Tropical Diseases (Verona, Italy) to compare efficacy and safety of ivermectin (single dose, 200 µg/kg) and thiabendazole (two daily doses of 25 mg/Kg for two days) to cure strongyloidiasis. The first patient was recruited on 6th December, 2004. Follow-up visit of the last patient was on 11th January, 2007. Consenting patients responding to inclusion criteria were randomly assigned to one of the treatment arms. Primary outcome was: negative direct and indirect (IFAT) tests at follow-up (4 to 6 months after treatment) or subjects with negative direct test and drop of two or more IFAT titers. Considering 198 patients who concluded follow-up, efficacy was 56.6% for ivermectin and 52.2% for thiabendazole (p = 0.53). If the analysis is restricted to 92 patients with IFAT titer 80 or more before treatment (virtually 100% specific), efficacy would be 68.1% for ivermectin and 68.9% for thiabendazole (p = 0.93). Considering direct parasitological diagnosis only, efficacy would be 85.7% for ivermectin and 94.6% for thiabendazole (p = 0.21). In ivermectin arm, mild to moderate side effects were observed in 24/115 patients (20.9%), versus 79/108 (73.1%) in thiabendazole arm (p = 0.00).ConclusionNo significant difference in efficacy was observed, while side effects were far more frequent in thiabendazole arm. Ivermectin is the drug of choice, but efficacy of single dose is suboptimal. Different dose schedules should be assessed by future, larger studies.Trial Registration Portal of Clinical Research with Medicines in Italy 2004–004693–87

Toxic Plants Used in Ethnoveterinary Medicine in Italy

This study was conducted to document the use of toxic or potentially toxic plants for the treatment of ailments in livestock and pets in ethnoveterinary practice in Italy. More than 250 of the entities used (81% for curative purposes) can be toxic unless dosed appropriately. Many (55%) are dietary supplements. The list included 186 species (45%) for internal and 175 (55%) for external use, many used in places where animals are kept. The species belong to 71 families, among which the Fabaceae predominate. The purpose of the study was to provide information that can be validated and associated with correct determination, permitting even potentially dangerous plants to be used in veterinary practice.

Prevalence of ‘Borderline’ Values of Cardiovascular Risk Factors in the Clinical Practice of General Medicine in Italy

The prevalence of patients with 'borderline' levels of cardiovascular risk factors has been rarely investigated, being often reported in studies evaluating abnormal values of these parameters. The BORDERLINE study represents a pilot experience to primarily identify the prevalence of 'high-normal' conditions, such as pre-hypertension, lipid and glucose levels in the upper range of normality in the setting of general practice in Italy. The aim of this study was to evaluate the prevalence of patients with 'borderline' values of cardiovascular risk factors in Italy. Involved physicians were asked to evaluate the first 20 outpatients, consecutively seen in June 2009. Data were collected in a study-designed case-report form, in which physicians identified thresholds rather than reported absolute values of several clinical parameters. High-normal values were defined as follows: blood pressure (BP) 130-140/85-90 mmHg; total cholesterol 180-200 mg/dL; low-density lipoprotein cholesterol (LDL-C) 130-150 mg/dL; high-density lipoprotein cholesterol (HDL-C) 30-40 mg/dL in males and 40-50 mg/dL in females; triglycerides 130-150 mg/dL and fasting glucose 100-110 mg/dL. Fifty-three Italian physicians provided valuable clinical data on 826 individual outpatients, among which 692 (83.7%, 377 women, mean age 60.9 ± 13.2 years, body mass index 26.6 ± 5.0 kg/m2) were included in the present analysis. Prevalence of borderline values of systolic BP and total cholesterol levels were at least comparable with those in the normal limits of the corresponding parameters, whereas prevalence of borderline diastolic BP, LDL-C, HDL-C, triglycerides and fasting glucose levels was significantly lower than that of normal values, but higher than that of abnormal values of the corresponding parameters. Using this sample of healthy subjects in the setting of general practice in Italy, our results demonstrated a relatively high prevalence of borderline values of cardiovascular risk factors, which was at least comparable with that of normal, but significantly higher than that of abnormal thresholds. These preliminary findings may prompt more extensive investigations in the area of 'borderline' cardiovascular risk. This information may, in fact, potentially enable the design of more effective prevention strategies in the future to limit the burden of cardiovascular disease in the general population in Italy. Received for publication 4 March 2011; accepted for publication 20 April 2011.

University Medicine in Italy: an exemplary “case report” of several unresolved criticities

The present role, space, task, mission, function, and outcome of University Medicine in Italy are briefly examined, taking as a pure and trivial pretext the actual professional activity of single, representative physician who changed his role at the same specialistic Department of the same University Hospital, by covering an University role in the past five years, after working at the same facility as an Hospital-affiliated specialist in charge of the same Medical Division during the previous 14 years. The lights and shadows of assistential and academic medicine organisation and integration in Italy are the starting point of our preliminary observations, which may be potentially extended to the University Medicine as a whole, from an organisative, functional, and especially ergonomic point of view.