Search

The progressive cutting of hospital beds in some health systems, together with the increased needs related to the aging population, has led to the phenomenon of patients hospitalized outside the appropriate ward (outliers). This is particularly relevant in the context of Internal Medicine. Despite its relevance in daily clinical practice, available evidence for the potential impact of this phenomenon is limited. The aim of this study is to evaluate the effects of this situation on patients' outcomes [ABSTRACT FROM AUTHOR]

Non-invasive ventilation (NIV) is a rapidly spreading method in the last years even outside of intensive care units for the treatment of patients with acute respiratory failure. Its use in general medical wards in Italy and Europe is still largely incomplete and there are clear gaps in terms of organization, training, selection, and patient monitoring. If these gaps are filled, NIV has also proven to be effective in general medical wards, especially if they have a critical care area. This publication reports the data collected by an Italian regional survey on the use of NIV in internal medicine, highlighting positive and negative aspects. [ABSTRACT FROM AUTHOR]

Since Internal Medicine (IM) is the most frequent setting of hospitalization for both patients with advanced liver disease and those with comorbidities and risk factors for infection, through this position paper FADOI aims to promote and disseminates its vision regarding the current and potential role of IM in managing hepatitis C virus (HCV) infection (screening, diagnosis, linkage-to-care, treatment). The Internist plays an important role in identifying new cases, in selecting the appropriate diagnostic work-up for liver disease staging and prognosis, and in initiating antiviral therapy, coordinating care and communication with other specialists, the Hepatology outpatient clinic and General Practitioners. Since the Internist is naturally accustomed to the management of multiple comorbidities, he has a fundamental role in the identification of extrahepatic diseases associated with HCV infection and in the diagnosis of comorbidities, some of which are potential factors of liver disease progression. Moreover, in the prescription of the antiviral therapy, it is important to consider the possible drug interactions, and this ideally fits the role of the Internist who can weigh the risk/benefit ratio of possible alternatives, by considering the patient's clinical situation, especially in case of multiple comorbidities. Moreover, it seems appropriate that the ability to prescribe antiviral therapy is guaranteed to all IM hepatology clinics, favoring a spread of awareness as well as an increase in national coverage and therefore patient access to therapies. The network of IM can also contribute to homogenizing the management policies of HCV treatment, which sometimes differ between Italian Regions. [ABSTRACT FROM AUTHOR]

Since a large number of patients with chronical medical diseases die in hospital, often in an internal medicine ward, internists are urged to improve their expertise in end-of-life (EOL) care, which is a neglected part of their academic education. Recently, FADOI (the Italian Federation of the Associations Hospital Doctors on Internal Medicine) has addressed EOL-medicine in many ways, promoting many scientific meetings on this and allied topics, providing educational material made available in its website on a free basis and establishing an ad hoc Committee charged with the task of organizing dedicated events annually. The Committee has also elaborated a series of recommendations on EOL-care in internal medicine (a decalogue), reflecting largely shared visions. It has been endorsed also by ANIMO (the Association of the Italian Nurses working in an Internal Medicine Department). The decalogue for EOL care in internal medicine is issued here, and calls for its diffusion and implementation. The driving concept is that doctors and nurses must feel responsible for disregarding appropriate EOL-care for the dying patients, because delaying it means to add suffering and discomfort to them in the final phase of their existence. [ABSTRACT FROM AUTHOR]