Finasteride in the treatment of men with frontal male pattern hair loss

Background: Finasteride, a specific inhibitor of type II 5α-reductase, decreases serum and scalp dihydrotestosterone and has been shown to be effective in men with vertex male pattern hair loss. Objective: This study evaluated the efficacy of finasteride 1 mg/day in men with frontal (anterior/mid) scalp hair thinning. Methods: This was a 1-year, double-blind, placebo-controlled study followed by a 1-year open extension. Efficacy was assessed by hair counts (1 cm² circular area), patient and investigator assessments, and global photographic review. Results: There was a significant increase in hair count in the frontal scalp of finasteride-treated patients (P < .001), as well as significant improvements in patient, investigator, and global photographic assessments. Efficacy was maintained or improved throughout the second year of the study. Finasteride was generally well tolerated. Conclusion: In men with hair loss in the anterior/mid area of the scalp, finasteride 1 mg/day slowed hair loss and increased hair growth. (J Am Acad Dermatol 1999;40:930-7.)     

Length of stay as risk factor for inappropriate hospital days: interaction with patient age and co‐morbidity

Rationale, aims and objectives The likelihood of a hospital day being inappropriate depends on patient characteristics, on the organization of in‐hospital care and on the co‐ordination between hospital care and the rest of the health care sector. The aim of the study was to assess if certain socio‐demographic and medical factors affect inappropriate hospital stay including possible interactions between age and co‐morbidity. Methods To determine the appropriateness of length of hospitalization, a prospective study was carried out using the European version of the Appropriateness Evaluation Protocol (AEP). A total of 438 hospital days of stay was analysed in medical wards of a university‐affiliated teaching hospital in the North of Italy for 3 days in September 2010. Results 44.6% of hospitalization days were classified as inappropriate. Unjustified hospital use was more frequent in patients whose hospital length of stay exceeded 10 days. Age and co‐morbidity were not per se risk factors for inappropriateness; however, in young patients hospitalized for more than 10 days, absence of chronic illness was a predictor. Conservative patient management, lack of discharge planning and delays in scheduling diagnostic tests or therapeutic interventions were the most common causal or contributory doctor‐ and hospital‐related factors. Conclusions Doctor attitudes and hospital organization are still among the most common reasons for inappropriate in‐hospital days of care. Monitoring whether the length of stay is appropriate combined with protocol interventions for scheduling of diagnosis, treatment and discharge are likely to improve efficiency in this area of medical care.     

Economic crisis and challenges for the Greek healthcare system: the emergent role of nursing management

notara v., koupidis s.a., vaga e. & grammatikopoulos i.a. (2010) Journal of Nursing Management 18 , 501–504
Economic crisis and challenges for the Greek healthcare system: the emergent role of nursing management Background Despite several reform efforts, the Greek health care system still faces problems related to misdistribution of trained health staff and finance between geographical areas. Aim The objectives of the present study were to describe the current situation of the delivery of the healthcare service in Greece, to explore the basic implications of the economic crisis from a nursing management perspective and to examine future practices opening a debate in policy developments. Key issue The principal finding of this study was the serious shortage of trained nurses, the imbalances in nursing personnel, an excess of doctors and the complete absence of a Primary Healthcare System in civil areas provided by general doctors. Conclusion It is important that health care policy makers become aware and seriously consider rearranging the Health Care System to become more effective and efficient for the population (client). Special attention should be paid to strengthening areas such as primary health care, public health and health promotion in the direction of minimizing the demand of hospital services. Implications for nursing management Any implementation of major health care reforms should consider seriously the role of the nursing management which formulates the substantial link between the health services and the patient.