77,035 results on '"Male"'
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2. MATTHEW ARNOLD’S ‘THE FORSAKEN MERMAN’ AND ‘THE NECKAN’AS REFLECTIONS OF VICTORIAN FEARS
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Dijana D. Tica
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male ,female ,Victorian ,conflict ,religion ,Philology. Linguistics ,P1-1091 - Abstract
Based on folk tales of Northern European nations, Arnold’s poems ‘The Forsaken Merman’ (1849) and ‘The Neckan’ (1853), both tell a story of human women who marry sea creatures, mermen, and replace their home on the land with the mermen’s underwater world. By crossing the boundaries between their worlds, they cause numerous problems, most significantly the tension resulting from their different religious beliefs. In ‘The Forsaken Merman’, Margaret, the merman’s wife, fearing that her soul will be damned because of her marriage to a pagan, decides to rejoin the human world on the most important Christian holiday, Easter. In ‘The Neckan’, in order to comfort his wife, the Neckan goes to the human world to find a priest who would be willing to baptise him, but he is rejected because he is a ‘monster’ who cannot be saved. The paper will examine the way in which Arnold’s poems reflect the fears of the Victorian era as well as his own anxieties. This will be accomplished by comparing the two opposite worlds of the poems – the human world of everyday activities, rules, laws, and expectations; and the mermen’s home, the mysterious, colourful, and peaceful world of sea-beasts. In addition, the paper will analyse the reversal of traditional gender roles and re-examine literary, cultural, and social stereotypes. The paper will also attempt to find a connection between the main topics of these poems and Arnold’s life and career of a poet and literary critic.
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- 2023
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3. [The care pathway of patients with diffuse large B-cell lymphoma described through Italian administrative healthcare data.]
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Dondi L, Ronconi G, Dondi L, Calabria S, Dell'Anno I, Piccinni C, Addesi A, Esposito I, and Martini N
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- Humans, Italy, Male, Aged, Female, Middle Aged, Aged, 80 and over, Adult, Rituximab administration & dosage, Kaplan-Meier Estimate, Hematopoietic Stem Cell Transplantation, Health Care Costs statistics & numerical data, Vincristine administration & dosage, Follow-Up Studies, Cyclophosphamide administration & dosage, Cyclophosphamide therapeutic use, Doxorubicin administration & dosage, Prednisone administration & dosage, Prednisone therapeutic use, Lymphoma, Large B-Cell, Diffuse drug therapy, Lymphoma, Large B-Cell, Diffuse therapy, Lymphoma, Large B-Cell, Diffuse epidemiology, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Antineoplastic Combined Chemotherapy Protocols economics, Databases, Factual
- Abstract
Introduction: The diffuse large B-cell lymphoma (Dlbcl) is the most common non-Hodgkin lymphoma and at highest incidence among the elderly. Despite the improved outcomes of patients treated with the first-line (1L) standard of care until the end of 2022, composed by rituximab and polychemotherapy (R-Chop), during the last 20 years, the rate of relapsed and refractory Dlbcl (rrDlbcl) remains elevated. This study has identified and analyzed patients newly diagnosed with Dlbcl and treated with 1L, from the perspective of the Italian National Health Service (Ssn)., Methods: From the administrative database of Fondazione Ricerca e Salute (ReS) including ~5.5 million inhabitants/year in Italy, adults with a new in-hospital Dlbcl diagnosis (index date) and treated with 1L in 2018, 2019, 2020 and 2021 were identified and characterized in terms of demographics and comorbidities during a period (from 4 to 8 years) preceding index date. From 1 to 4 years following index date (follow-up), overall survival (Kaplan-Meier curves), percentage distribution of patients by line of therapy including dispensation/administration of chemo-immunotherapy, hemopoietic stem cell transplantation (Hsct), and direct healthcare costs charge to the Ssn, were evaluated., Results: Overall, from the ReS database, 206 patients newly diagnosed with Dlbcl and treated with 1L from 2018 to 2021 in Italy (incidence from 0.9 to 1.7 x100,000 adult inhabitants) were identified. They were mainly older (median age 68 [56; 75] years), males (56%) and affected by ≥2 comorbidities (52%), mostly cardiometabolic. During 4 years of follow-up, 56% of cases in 2018 survived. During the first follow-up year: 73%, 80%, 100% and 35% of cases in 2018, 2019, 2020 and 2021, respectively, received a 2L; 42% and 64% of cases in 2018 and 2020, respectively, received a 3L. At least one Hsct was found as a 2L among cases in 2018, 2020 and 2021. On average, each patient newly diagnosed with Dlbcl and treated with 1L from 2018 to 2021 caused a total expenditure directly charged to the Ssn ranging from € 20,000 to € 30,000 during the first follow-up year (chemo-immunotherapy accounted for 40-53%), which reduced with time in favor of other drugs and Hsct., Conclusions: This analysis confirms the high rate of rrDlbcl and the high economic impact charged to the SSN to support first the chemo-immunotherapy, then the chronic care and the absence of standardized further lines of therapy for patients with rrDlbcl.
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- 2024
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4. [Is there a correlation between increasing hospital falls and Covid-19 infection? Retrospective study on the entire hospital population.]
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Gonella F, Valenti A, Testa O, Ricotti A, Passi S, and Mitola B
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- Humans, Retrospective Studies, Risk Factors, Male, Aged, Female, Aged, 80 and over, Middle Aged, Hospitals statistics & numerical data, Risk Management, Accidental Falls statistics & numerical data, COVID-19 epidemiology
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Introduction Falls are the second leading cause of accidental or unintentional death worldwide. In hospital falls represent a relevant health problem, in particular after their increasing since Covid year 2020. The aim of this study is to evaluate correlation between falls and Covid infection., Methods: Risk Management Unit at Mauriziano hospital analyzed in the present observational study possible correlation with Covid Pandemic and falls risk factors, through comparison of patients falls occurred during year 2021 in Covid and no-Covid wards. The primary outcome of the study is the evaluation of relationship between falls and Covid infection. The secondary outcome is identification of falls risk factors., Results: No direct correlation between falls and Covid-19 infection was found. Among falls risk factors, the most interesting emerged is the fall itself that enhances the risk of relapse., Discussion: Increasing in patients falls since 2020 could be affected indirectly by strong hospital organization modifications during Covid pandemic.
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- 2024
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5. [Molnupiravir reduces symptoms duration but does not decrease hospitalizations or deaths in vaccinated adults with Covid-19.]
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Kurotschka PK, Ebell MH, and Serafini A
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- Humans, COVID-19 Vaccines administration & dosage, Adult, Male, Middle Aged, Female, Time Factors, Aged, Hospitalization statistics & numerical data, COVID-19 prevention & control, COVID-19 mortality, COVID-19 Drug Treatment, Antiviral Agents therapeutic use, Antiviral Agents administration & dosage, Cytidine analogs & derivatives, Cytidine therapeutic use, Hydroxylamines therapeutic use, Hydroxylamines administration & dosage
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- 2024
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6. [Nirmatreolvir-ritonavir (Paxlovid) leads to no reduction of symptoms or hospitalizations in vaccinated or unvaccinated high-risk adults with Covid-19.]
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Kurotschka PK, Ebell MH, and Serafini A
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- Humans, Drug Combinations, Adult, Male, COVID-19 Vaccines administration & dosage, Middle Aged, COVID-19 prevention & control, Female, Aged, Antiviral Agents administration & dosage, Treatment Outcome, Ritonavir administration & dosage, Hospitalization statistics & numerical data, COVID-19 Drug Treatment
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- 2024
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7. [Ventricular tachycardia: the cause you do not think about].
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Dal Passo B and Tonet E
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- Humans, Electrocardiography, Male, Tachycardia, Ventricular
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- 2024
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8. [A pathognomonic case of isolated right ventricular infarction].
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Cortese F, Clemente M, Di Marino S, Costantino MF, and Luzi G
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- Humans, Male, Middle Aged, Heart Ventricles diagnostic imaging, Myocardial Infarction diagnosis
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- 2024
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9. [Giant tricuspid annular calcification and kyphoscoliosis: is there a link?]
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Bufano G, Mazzeo P, Corbo MD, Fioretti V, Smaldone C, and Stabile E
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- Humans, Male, Aged, Heart Valve Diseases complications, Heart Valve Diseases diagnostic imaging, Tomography, X-Ray Computed, Echocardiography, Calcinosis complications, Calcinosis diagnostic imaging, Tricuspid Valve diagnostic imaging, Kyphosis complications, Scoliosis complications
- Abstract
Although mitral annular calcification is a common degenerative condition of the fibrous mitral annulus, tricuspid annular calcification, especially isolated, is rare. We report the case of a 73-year-old male, with a history of hypertension and severe kyphoscoliosis, referred to the emergency department for progressive dyspnea and leg swelling. Echocardiography revealed a dilated right heart with a homogeneous, hyperechoic, crescent shaped mass along the tricuspid annulus. Computed tomography confirmed the calcific nature of the lesion. Right heart catheterization revealed mild pre-capillary pulmonary hypertension and a mild spirometrically-defined restrictive ventilatory defect. Kyphoscoliosis has recently been associated with alterations in cardiac deformation and with an increased risk of restrictive lung disease. In our patient, we hypothesized that both these anomalies could have led to premature tricuspid annular degeneration resulting in a giant tricuspid calcification.
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- 2024
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10. [Effect of Plasmafiltration and Adsorption in Cocaine Abuse: A Case Report].
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Coviello N, Carella A, Loizzo G, Prisciandaro C, Tarantino G, Bonfantino MV, and D'Elia F
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- Humans, Male, Middle Aged, Rhabdomyolysis therapy, Rhabdomyolysis chemically induced, Cocaine-Related Disorders complications
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Rhabdomyolysis is one of the principal causes of acute kidney disease. Multiple endogenous and exogenous causes could start this process: cocaine addiction, a social phenomenon present in our Country among young adults, is one exogenous causes. Natural stimulating alkaloid cocaine has toxic action on multiple systems, principally central nervous system and cardiovascular system. Etiopathogenesis is related either to changes in local and systemic hemodynamics, or to direct damage caused by myofibril accumulation, or to immunological events leading to vasculitis or thrombotic microangiopathies. Scientific evidences describe different therapeutic approaches: supportive therapy, extracorporeal treatments and possible removal of the pathogenic noxa, and the therapeutic apheresis plays a role yet to be confirmed in this field. We describe the case of a 52-year-old man, hospitalized in the Cardiological Intensive Care Unit of our hospital, due to serious alterations in the indices of myocardiocytonecrosis and liver function, following cocaine abuse. During hospitalization, renal function indices worsened associated to diuresis contraction and onset of metabolic acidosis, not responsive to medical therapy. Also in consideration of myoglobin high circulating levels, related to rhabdomyolysis, the patient went under a cycle of selective apheresis using adsorption with a TR350 cartridge associated to hemodialysis: after two adsorption sessions, the patient resumed spontaneous diuresis with progressive normalization of the blood indices., (Copyright by Società Italiana di Nefrologia SIN, Rome,Italy.)
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- 2024
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11. [ADPKD and IPMN: Mere Coincidence or Double Trouble?]
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Kola K, De Rosa LI, Catania M, Brambilla Pisoni M, Tunesi F, Farinone S, Petrone M, Manunta P, Vezzoli G, and Sciarrone Alibrandi MT
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- Humans, Adenocarcinoma, Mucinous pathology, Adenocarcinoma, Mucinous diagnosis, Middle Aged, Male, Carcinoma, Papillary pathology, Carcinoma, Papillary diagnosis, Pancreatic Neoplasms diagnosis, Pancreatic Neoplasms pathology, Pancreatic Intraductal Neoplasms pathology, Polycystic Kidney, Autosomal Dominant complications, Polycystic Kidney, Autosomal Dominant genetics
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This article constitutes a review of the existing literature on the potential correlation between autosomal dominant polycystic kidney disease (ADPKD) and intraductal papillary mucinous neoplasms (IPMN) of the pancreas. Additionally, it presents a clinical case where familiarity for both pathologies was observed, derived from the direct experience of our clinic, reinforcing the hypothesis of a possible common pathogenetic pathway. The review focuses on the potential genetic correlation between these two pathologies within the realm of ciliopathies, emphasizing the importance of targeted screening and monitoring strategies to detect pancreatic complications early in patients with ADPKD. Furthermore, it highlights the complexity in the clinical management of these rare conditions and underscores the importance of early diagnosis in optimizing clinical outcomes., (Copyright by Società Italiana di Nefrologia SIN, Rome,Italy.)
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- 2024
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12. [Stenotic FAV: Success of the Collaboration Between Spoke and HUB].
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Nicotera R, Pingitore A, Prunestì P, Chiarella S, Donato C, Mazzitello G, Bovino M, and Cannistrà P
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- Humans, Male, Middle Aged, Female, Aged, Ultrasonography, Doppler, Color, Graft Occlusion, Vascular diagnostic imaging, Graft Occlusion, Vascular etiology, Arteriovenous Shunt, Surgical, Renal Dialysis
- Abstract
The arteriovenous fistula constitutes the vascular access of first choice in hemodialysis. We present three clinical cases that highlight the resolution in interventional radiology of venous stenosis, one of the major complications. Clinical monitoring and instrumental diagnostics with color Doppler ultrasound have prevented the failure of the AVF due to high risk of thrombosis. The angiographic interventions, thanks to the collaboration between Spoke and Hub, were completed without complications., (Copyright by Società Italiana di Nefrologia SIN, Rome,Italy.)
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- 2024
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13. [Familial Hypocalciuric Hypercalcemia Type 1 Likely Secondary to a New Inactivating Mutation of CASR].
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Zanchelli F, Giudicissi A, Neri L, Sgarlato V, Bruno PF, Ruggeri M, Signorotti S, Apuzzo D, Notaro E, and Buscaroli A
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- Humans, Mutation, Male, Female, Receptors, Calcium-Sensing genetics, Hypercalcemia genetics, Hypercalcemia diagnosis, Hypercalcemia congenital
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Familial Hypocalciuria Hypercalcemia (FHH) is an inherited disease with autosomal dominant transmission characterized by the presence of usually mild-to-moderate hypercalcemia, hypophosphatemia, hypocalciuria, and normal or moderately increased PTH values. Generally, FFH is asymptomatic although symptoms related to elevated plasma calcium values such as asthenia, intense thirst, polyuria, polydipsia or confusional state may occur. Three types of FHH, which differ in the genetic alterations underlying the condition, are described. The majority of FHH cases are classified as type 1 (about 65 percent of cases), due to mutation in the gene for the calcium-sensitive receptor CASR, expressed on chromosome (Chr) 3q13.3-21, which encodes for a calcium-sensitive receptor G-protein-coupled protein of the plasma membrane. FHH types 2 and 3 are due to GNA11 and AP2S1 mutations, respectively, and other genes involved in the pathogenesis of the disease have likely yet to be identified. Rarely, familial hypocalciuric hypercalcemia may not recognize a genetic cause but be caused by autoantibodies directed against CASR. The frequency of the disease is not known and is estimated, probably by default, because of paucisymptomatic presentation of the disease, to be around 1:80000 cases. Recognition of FHH is especially important for differential diagnosis with primary hyperparathyroidism, which has a much higher incidence, about 1:1000 cases. This allows for the identification of patients at risk for chondrocalcinosis and/or pancreatitis. Clinical suspicion must be raised in cases of hypercalcaemia associated with hypocalciuria, and genetic analysis is fundamental in the differential diagnosis toward forms of primary hyperparathyroidism that might result in unnecessary surgical interventions. We describe a clinical case in which a novel inactivating mutation of CASR leading to FHH type 1 was found., (Copyright by Società Italiana di Nefrologia SIN, Rome,Italy.)
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- 2024
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14. [Clinical Thermography for the Management of Hemodialysis Vascular Access].
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Gatta G, Scarlatella A, Aucella F, Nardella M, Perpetuini D, Tritto M, Cardone D, Lomonte C, Merla A, and Aucella F
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- Humans, Male, Middle Aged, Thermography methods, Renal Dialysis, Arteriovenous Shunt, Surgical
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The arteriovenous fistula (AVF) represents the favorite vascular access in individuals with chronic kidney disease (CKD). Because AVF is a guarantee of survival for these patients, proper surgical packing and a timely follow-up program is crucial. Although a good objective examination of the limb site of FAV provides useful information both in planning the fistula surgery and in its surveillance and monitoring, it is now well established that the advent of instrumental diagnostics (ultrasonography, digital angiography, Angio-TC, MRI) has contributed significantly to improving primary and secondary patency of FAV and early diagnosis of vascular access complications. In this area, clinical thermography, a noninvasive and nondestructive diagnostic technique for assessing minute surface temperature differences, has shown good potential for the assessment of AVF. In fact, thermographic analysis of a limb site of AVF shows an increase in temperature at the site of the anastomosis and along the course of the arterialized vein. In this article we report our experience on the use of thermography in preoperative evaluation and postoperative surgical packing of an AVF. Further studies could validate the use of clinical thermography as a diagnostic technique to be used in the field of hemodialysis vascular accesses., (Copyright by Società Italiana di Nefrologia SIN, Rome,Italy.)
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- 2024
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15. Cefiderocol utilization in lung transplant recipients at a single center.
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Persaud PN, Xhemali X, Neuhaus K, Budev M, and Lum J
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- Humans, Retrospective Studies, Middle Aged, Female, Male, Adult, Aged, Microbial Sensitivity Tests, Lung Transplantation adverse effects, Anti-Bacterial Agents therapeutic use, Anti-Bacterial Agents administration & dosage, Pseudomonas Infections drug therapy, Pseudomonas aeruginosa drug effects, Cefiderocol, Cephalosporins therapeutic use, Drug Resistance, Multiple, Bacterial, Transplant Recipients statistics & numerical data
- Abstract
Background: Multidrug-resistant organisms are increasing and are a significant cause of mortality among lung transplant recipients (LTRs). To assist with this issue, novel pharmacotherapies are being developed. This study describes the utilization of a novel antibiotic, cefiderocol (FDC), in LTRs where limited data exists in the current literature. We primarily assessed the clinical indications, duration of therapy, resistance, and adverse effects., Methods: Conducted as a single-center retrospective review, this study included adult LTRs who received FDC for at least 24 h. Data, extracted from electronic medical records, encompassed patient demographics, transplant history, antimicrobial dosing, adverse effects, bacterial cultures, and outcomes. The research protocol received institutional review board approval., Results: FDC exhibited effectiveness against multidrug-resistant Pseudomonas aeruginosa, with 26% 30-day mortality and microbiological clearance observed in nine out of 13 cases. Notably, FDC was used in diverse clinical settings, including for prophylaxis, empiric, and targeted treatment., Conclusion: Further studies are needed to evaluate optimal clinical indications for FDC use in LTRs., (© 2024 The Author(s). Transplant Infectious Disease published by Wiley Periodicals LLC.)
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- 2024
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16. [A "strange" premature ventricular complex: from ECG evaluation to genetics].
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Caprio MV, Di Domenico A, Merlo M, and Sinagra G
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- Humans, Male, Ventricular Premature Complexes diagnosis, Ventricular Premature Complexes physiopathology, Electrocardiography
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- 2024
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17. [Cardio Delirium Day: national study on the prevalence of delirium in Italian cardiology wards].
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Frongillo D, Barisone M, Gilardi R, Usmiani T, and Falsini G
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- Humans, Italy epidemiology, Male, Female, Aged, Prevalence, Aged, 80 and over, Hospitalization statistics & numerical data, Cardiology Service, Hospital, Logistic Models, Intensive Care Units statistics & numerical data, Delirium epidemiology, Delirium diagnosis
- Abstract
Background: To date delirium prevalence in the adult acute Italian hospital cardiac population is unknown. In a multicenter study, we assessed the prevalence of delirium over a single day among a population of patients admitted to acute cardiac hospital wards in Italy., Methods: This is a point prevalence study (called "Cardio Delirium Day") which involved 55 Italian cardiologic centers (23 North, 18 Central, 12 South, 2 Sardinia) that collected data on 152 patients older than 65 years hospitalized on March 15, 2023. Delirium was assessed on the same day in all patients using the Confusion Assessment Method for the Intensive Care Unit algorithm, a validated and briefly administered tool which does not require specialized training. We also collected data about clinical variables, functional and nutritional status, dementia, comorbidity, medications, and physical restraints., Results: The mean sample age was 79.0 ± 10 years (33% female). Delirium was diagnosed in 25 patients (16.4%); 17.1% were hospitalized in the intensive cardiac care unit and 13.8% in the cardiology ward (p=NS). Hyperactive was the commonest subtype (48%), followed by mixed (36%) and hypoactive type (8%). In a multivariate logistic regression, male sex (odds ratio [OR] 3.81, 95% confidence interval [CI] 1.18-12.26; p=0.025), chronic obstructive pulmonary disease (OR 0.24, 95% CI 0.063-0.66; p=0.008), sensorial deficit (OR 3.75, 95% CI 1.18-11.95; p=0.025), sleep deprivation (OR 5.81, 95% CI 1.47-22.9; p=0.012) and the presence of ≥3 precipitating factors (OR 7.63, 95% CI 2.32-25.2; p=0.001) were independent predictors of delirium., Conclusions: Delirium occurred in 16.4% of patients in a cardiology setting. The "Cardio Delirium Day" project might become a useful method to assess delirium over time and sensitize the interest and the culture of Italian cardiology in this important aspect of hospital care.
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- 2024
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18. [Life insurance after percutaneous revascularization in a patient with severe left ventricular dysfunction and left bundle branch block: benefit of revascularization in the post-REVIVED-BCIS2 era].
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Piedimonte G, Rolfo C, Tomassini F, Galluzzo A, Cerrato E, Pavani M, Franzè A, and Varbella F
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- Humans, Male, Coronary Occlusion surgery, Coronary Occlusion complications, Coronary Occlusion therapy, Aged, Severity of Illness Index, Myocardial Revascularization methods, Bundle-Branch Block physiopathology, Bundle-Branch Block therapy, Percutaneous Coronary Intervention methods, Ventricular Dysfunction, Left
- Abstract
The recent results of the REVIVED-BCIS2 randomized clinical trial added further controversy on the utility of myocardial revascularization in patients with chronic coronary syndrome with reduced ejection fraction. However, coronary artery disease still represents the leading cause of heart failure with reduced ejection fraction, with the potential for functional recovery following complete revascularization due to the restoration of the so-called hibernating myocardium. We report an emblematic case of a patient with recovery of contractile function and normalization of the left bundle branch block after percutaneous coronary intervention of the right coronary artery chronic total occlusion.
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- 2024
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19. [An unusual... dissection].
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Calò L, Botti A, Carretta T, De Rosa F, Fiorini R, Pedrazzini M, and Tortorella G
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- Humans, Aged, 80 and over, Male, Fatal Outcome, Tomography, X-Ray Computed, Vascular Fistula surgery, Vascular Fistula diagnosis, Vascular Fistula diagnostic imaging, Aortic Dissection surgery, Aortic Dissection diagnosis, Aortic Dissection diagnostic imaging, Pulmonary Artery diagnostic imaging
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Pulmonary artery dissection is a rare and fatal disease. Diagnosis is mainly made during autopsy because most patients die suddenly due to pulmonary artery dissection in the pericardium resulting in pericardial tamponade. The optimum management is not clearly defined because of the paucity of cases in the literature. We describe the case of an 81-year-old man, affected by rheumatoid arthritis and with history of aortic valve replacement surgery, who attended an emergency department for non-specific symptoms, started complaining of chest pain rapidly deteriorated into cardiac shock. Computed tomography scan, performed on suspicion of an acute aortic pathology and/or a pulmonary embolism, allowed the identification of pulmonary artery dissection associated with aorto-pulmonary fistula. Despite early diagnosis in the emergency department, the outcome was unfortunately fatal.
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- 2024
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20. [The organisation of outpatient medical and nursing clinics for the follow-up of patients after hospitalization for a myocardial infarction or heart failure].
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Avanzini F, Amodeo R, Colombo L, Corticelli A, Saltafossi D, Chiappa L, Iacuitti G, Bova C, Paone MG, Elli S, Santambrogio M, Colognesi S, Conti A, and Achilli F
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- Humans, Follow-Up Studies, Female, Male, Aged, Feasibility Studies, Patient Discharge, Middle Aged, Ambulatory Care Facilities organization & administration, Italy, Ambulatory Care, Aftercare, Heart Failure nursing, Heart Failure therapy, Myocardial Infarction nursing, Myocardial Infarction therapy, Hospitalization
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. The organisation of outpatient medical and nursing clinics for the follow-up of patients after hospitalization for a myocardial infarction or heart failure., Introduction: Guidelines suggest careful monitoring of patients after acute heart failure (AHF) or acute myocardial infarction (AMI)., Objective: To describe the implementation of the 'accompanied discharge' (DIMACC) pathway for patients admitted for AHF or AMI in the Cardiology Department of the Pio XI hospital in Desio, and to evaluate its feasibility., Methods: The DIMACC pathway was built following the recommendations of international guidelines and with the involvement of all the actors., Results: At discharge, the health objectives to be achieved are defined, and outpatient visits during the first year after hospitalization in the District outpatient clinics with the cardiology doctor and family nurses are booked. The patient stays in the outpatient clinic about 1.5 hours to complete at first, in half an hour, questionnaires on measures, symptoms, adherence, quality of life; then, to receive the nursing visit lasting half an hour for the assessment of the questionnaires, measurement of clinical parameters and counseling; and finally, to be visited by the cardiologist. During the pilot phase (6 months of recruitment and 1 year of follow-up) 168 patients (129 AMI and 39 AHF) followed the pathway: 4 (2.4%) patients died during the follow-up, 14 (8.3%) abandoned the pathway and 150 (89.3%) completed it., Conclusions: The implementation of the DIMACC pathway required an investment of time (about a year) and resources but the follow-up is feasible. The next phase will be the evaluation of the patient outcomes.
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- 2024
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21. [Frequency and reasons for missed nursing care: a cross-sectional study in Veneto Region hospital].
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Cengia MG, Palese A, Saiani L, Brugnaro L, Di Falco A, Mezzalira E, Costa C, and Ambrosi E
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- Cross-Sectional Studies, Humans, Male, Female, Italy, Adult, Surveys and Questionnaires, Middle Aged, Hospitals, Nursing Staff, Hospital, Nursing Care
- Abstract
. Frequency and reasons for missed nursing care: a cross-sectional study in Veneto Region hospitals., Introduction: Missed nursing care (MNC) encompasses clinical, relational, and emotional aspects of care that are neglected, delayed, or incomplete as performed by nurses., Aims: 1. To describe the frequency of MNC across various clinical settings within hospitals in the Veneto Region; 2. to identify the underlying motivations for MNC; 3. to analyze the relationship between the characteristics of nurses, organizational factors, and the perceived frequency of MNC., Methods: This cross-sectional exploratory study involved 12 healthcare organizations in the Veneto region. A total of 2,179 nurses and 159 coordinators participated, completing the Unfinished Nursing Care Survey questionnaire. Data was collected on the individual characteristics of the nurses and the organizations involved., Results: The least missed care activities included patient monitoring and surveillance, while the most missed were active/passive mobilization, supervision of support staff, and oral care. The primary reasons for MNC were related to insufficient human resources, unpredictability of workflow, and communication difficulties. Senior nurses were more likely to report MNC (OR 1.026; 95% CI 0.567-0.963), whereas those more satisfied with their role in the unit (OR 0.691; 95% CI 0.585-0.817) and those working in spoke hospitals (OR 0.739; 95% CI 0.567-0.963) were less likely to perceive missed nursing care., Conclusions: The study emphasizes that, generally, nurses perceive that they infrequently miss, omit, or delay care activities, particularly those related to patient monitoring and surveillance.
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- 2024
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22. [Testing an algorithm to identify disabilities using current health and social healthcare database: the experience of the Agency for Health Protection of the Metropolitan Area of Milan].
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Greco MT, Salvatori A, Gabellini E, Magnoni P, Mariani R, Belleli G, Cavaletti G, Citerio G, Moneta C, Sabatini C, Costantino MA, Casazza S, Bergamaschi W, and Russo AG
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- Humans, Italy epidemiology, Female, Male, Retrospective Studies, Middle Aged, Adult, Aged, Prevalence, Adolescent, Databases, Factual, Child, Young Adult, Child, Preschool, Disability Evaluation, Infant, Aged, 80 and over, Disabled Persons statistics & numerical data, Algorithms
- Abstract
Objectives: to describe prevalence of disability in the population of the Agency for Health Protection of Milan (ATS Milan), integrating current administrative healthcare, socio-healthcare, and social data; to classify disability with a diagnosis into a predominant structural and functional category according to the International Classification of Functioning, Disability and Health (ICF), supplementing it with additional levels of detail., Design: retrospective observational study., Setting and Participants: subjects residing in the territory of ATS Milan in the years from 2018 to 2022. Main outcomes measures: prevalence of disability in the population of ATS Milan from 2018 to 2022; average annual costs since disability diagnosis of the entire population and stratified by the most common ICF classifications., Results: the prevalence of disability ranges from 5.8% in 2018 to 8.4% in 2022. In general, women have a higher prevalence than men. However, there are significant differences in the gender distribution depending on the considered age group. The main disabilities (32.2%) affect the structures of the nervous system and mental functions, followed by disabilities identified solely by major prosthetic devices (9.4%) and sensory disabilities with alterations in sensory functions with the presence of a major device (5.2%). Analysis of average total annual per capita costs shows an upward trend with increasing years since the diagnosis., Conclusions: the definition of standardized tools, such as the selection from several available healthcare data provided by service suppliers, can be helpful in obtaining reliable data on the prevalence of disability in the population. This evidence can be useful in planning public health interventions to address the needs of this population. The work developed by ATS Milan has been carried out in alignment with the activities outlined in Mission 5 of the National Recovery and Resilience Plan (PNRR), in particular for the reform of disability legislation, which foresees the definition of standardized tools for the in-depth study of the epidemiological aspects of the phenomenon.
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- 2024
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23. [Right bundle branch block or ventricular preexcitation? Sometimes the solution lies in the middle].
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Arzenton M, Tezze R, Sarti A, and Vitali F
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- Humans, Pre-Excitation Syndromes diagnosis, Pre-Excitation Syndromes physiopathology, Male, Diagnosis, Differential, Middle Aged, Bundle-Branch Block diagnosis, Bundle-Branch Block physiopathology, Electrocardiography
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- 2024
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24. [Diffuse large B-cell lymphoma with heart involvement: the relevance of the multidisciplinary and multiparameter approach].
- Author
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Pennacchioni A, Nizzoli ME, Roncali M, Bavieri A, Rexhep D, Navazio A, Luminari S, and Tarantini L
- Subjects
- Humans, Fluorodeoxyglucose F18, Male, Radiopharmaceuticals, Middle Aged, Neoplasm Staging, Antineoplastic Combined Chemotherapy Protocols adverse effects, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Female, Aged, Lymphoma, Large B-Cell, Diffuse drug therapy, Heart Neoplasms complications, Positron-Emission Tomography
- Abstract
Lymphoma patients are at high risk of cardiovascular events due to anthracycline cardiotoxicity and, in rare cases, related to heart infiltration. The presence of cardiac masses adds further complexity to the management of lymphoma patients beyond myocardial chemotherapy-related toxicity, given possible unpredictable acute complications such as arrhythmias, atrioventricular block, myocardial ischemia, pericardial effusion and cardiac tamponade. Here we describe the clinical presentation and successful multidisciplinary management of diffuse large B-cell lymphoma with multifocal cardiac involvement identified by total body 18FDG positron emission tomography performed at disease staging.
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- 2024
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- View/download PDF
25. [Cardiac arrest in school: the role of teachers as BLS-D providers].
- Author
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Dini D, Benedetti T, Tomassacci E, Cesaretti M, Nicoletti S, Riminucci F, Silvestrini A, and Guerra F
- Subjects
- Humans, Cross-Sectional Studies, Surveys and Questionnaires, Female, Male, Adult, Electric Countershock methods, Middle Aged, Schools, Health Knowledge, Attitudes, Practice, Out-of-Hospital Cardiac Arrest therapy, School Teachers, Cardiopulmonary Resuscitation education, Defibrillators
- Abstract
Background: The implementation of BLS-D training courses in the school setting aims to increase the number of future citizens competent in the recognition and treatment of out-of-hospital cardiac arrest to increase overall survival. It is important to make teachers and students aware of their social responsibilities, consolidating collaboration with healthcare professionals. The present study investigates, through a cross-sectional cognitive survey, the perception of the importance of knowledge and diffusion of basic BLS manoeuvres and early defibrillation in the treatment of cardiac arrest., Methods: An anonymous questionnaire was sent to secondary school teachers, divided into 14 questions: 12 items in closed form according to the Delphi method and the 5-point Likert rating scale, and the last two with different response methods., Results: The total number of teachers who participated in the survey was 120. The majority of respondents believe that it is essential to know and transmit notions related to BLS-D to students, without the need to have an official certification as an instructor. Most of the teachers consider useful to have specific information on the placement and use of the defibrillator, to set reminder systems on life-saving manoeuvres and to share protocols on the management of cardiac arrest., Conclusions: The introduction of BLS-D training at school determines a constant increase in competent students and therefore the birth of a network of people educated in the management of out-of-hospital cardiac arrest. The teaching skills of teachers also allow them to identify the best strategies to make the learning method clear and valid for students. The autonomy of teachers in fulfilling the role of instructors is still poorly consolidated and shared, thus requiring the support of healthcare professionals.
- Published
- 2024
- Full Text
- View/download PDF
26. Il male del Sig. Nessuno.
- Author
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Ritratti, Elena
- Abstract
Copyright of Rivista Italiana di Conflittolgia is the property of Edizioni Labrys and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2022
27. «PERCHÉ RESTI SPETTATORE DELL’OPPRESSIONE?» (Ab 1,3) LA RIVELAZIONE NOTTURNA DI AUSCHWITZ.
- Author
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Tangorra, Giovanni
- Abstract
Auschwitz continues to raise queries. Starting from the dialectic between Word and Silence in God, that emerges from the Jewish-Christian revelation, the article proposes to rekindle their memory and the participation, drawing a panorama of the echoes aroused in the historical and theological debate. The exhibition is divided into four main topics: what we are talking about, a century under discussion, the theological repercussions, the discourse on God. The event is contextualized in the reflection on evil, emphasizing how much its unpublished forms, of a totalitarian and technological civilization, call for the introduction to new paradigms of approach. The examination extends to theology, which especially in the Christian sphere does not seem to have unanimously accepted the challenge of a fracture, supporting an optimistic conception of history that does not do justice to the cry of the oppressed. A core is the question of the lack of divine intervention, examined in the various solutions of Jewish and Christian literature, raising the question of how to speak of God after Auschwitz. [ABSTRACT FROM AUTHOR]
- Published
- 2022
28. Analysis of animal names in Serbian and English regarding their gender
- Author
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Ivanović Katarina M.
- Subjects
gender of nouns ,male ,female ,suppletion ,inflection ,Language and Literature - Abstract
This paper represents the comparison of animal names in Serbian and English considering their gender. Some basic characteristics of gender as a grammatical category in both languages are given, and a comparative analysis is made afterwards. Names denoting animal species are divided into several groups according to the area they inhabit, and, within each subcategory, the author analyzed the existence or nonexistence of separate lexemes denoting male and female animals of a certain species. The paper also considers the reasons for the (non)existence of separate lexemes for marking male and female animals in both languages. The main conclusion drawn from the comparison is that there are significant similarities in the analyzed languages. Different names for male and female animals are used for the species that people use in their households for different purposes or for the species that are specific because of the considerable physical differences between males and females. The analysis is also made according to grammatical criteria in order to determine the morphological processes used for marking males and females. As expected, inflection was used more often in the Serbian language, whereas suppletion was dominant in the English language.
- Published
- 2020
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- View/download PDF
29. [Two Cases of Pseudo-Bartter Syndrome in Childhood: When to Suspect a Rare Onset Pattern of Cystic Fibrosis].
- Author
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Vergine G, Fressola G, Ambroni M, Gessaroli M, Bigucci B, Mazzocco M, and Conte ML
- Subjects
- Humans, Male, Female, Hyponatremia etiology, Alkalosis etiology, Child, Preschool, Child, Cystic Fibrosis complications, Cystic Fibrosis genetics, Cystic Fibrosis diagnosis, Bartter Syndrome complications, Bartter Syndrome diagnosis, Bartter Syndrome genetics
- Abstract
Cystic fibrosis is a multisystem disease with extremely variable onset, symptoms and course. One of the onset modality but also a complication of the disease is the pseudo-Bartter syndrome, characterized by hyponatremia, hypochloremic dehydration and metabolic alkalosis in absence of any renal disease. This syndrome occurs more frequently in the first year of life and has a peak in the summer. In this article, we describe two cases of cystic fibrosis associated with pseudo-Bartter syndrome in childhood. Excluding every possible cause of metabolic alkalosis associated with hyponatremia was crucial for our diagnostic pathway, and the experience gained with the first case helped a lot with the second one., (Copyright by Società Italiana di Nefrologia SIN, Rome,Italy.)
- Published
- 2024
- Full Text
- View/download PDF
30. [When a Headache Is Not Just Hypertension: A Case of Atypical Hemolytic Uremic Syndrome in a Young Patient].
- Author
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D'Elia L, Cencioni L, Ferraresi M, Marciello A, Rizzuto A, Sandri L, and Perosa PM
- Subjects
- Humans, Male, Female, Atypical Hemolytic Uremic Syndrome complications, Atypical Hemolytic Uremic Syndrome diagnosis, Headache etiology, Hypertension complications, Hypertension etiology
- Abstract
Thrombotic microangiopathies represent a group of particularly serious pathologies that can cause a rapid worsening of renal function, especially in young subjects. Through the clinical case described, we will focus our attention on the clinical and laboratory manifestations of the pathology, on the diagnostics and on the therapies to be used. Recent therapeutic innovations for the treatment of this pathology will also be analysed., (Copyright by Società Italiana di Nefrologia SIN, Rome,Italy.)
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- 2024
- Full Text
- View/download PDF
31. [Gender cardio-oncology: inclusion and equity in the healthcare access for transgender and gender diverse people].
- Author
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Fioretti AM
- Subjects
- Humans, Female, Male, Medical Oncology, Cardiology, Cardio-Oncology, Health Services Accessibility, Transgender Persons
- Published
- 2024
- Full Text
- View/download PDF
32. Lifestyle and incident dementia: A COSMIC individual participant data meta‐analysis.
- Author
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Van Asbroeck S, Köhler S, van Boxtel MPJ, Lipnicki DM, Crawford JD, Castro-Costa E, Lima-Costa MF, Blay SL, Shifu X, Wang T, Yue L, Lipton RB, Katz MJ, Derby CA, Guerchet M, Preux PM, Mbelesso P, Norton J, Ritchie K, Skoog I, Najar J, Sterner TR, Scarmeas N, Yannakoulia M, Dardiotis T, Rolandi E, Davin A, Rossi M, Gureje O, Ojagbemi A, Bello T, Kim KW, Han JW, Oh DJ, Trompet S, Gussekloo J, Riedel-Heller SG, Röhr S, Pabst A, Shahar S, Rivan NFM, Singh DKA, Jacobsen E, Ganguli M, Hughes T, Haan M, Aiello AE, Ding D, Zhao Q, Xiao Z, Narazaki K, Chen T, Chen S, Ng TP, Gwee X, Gao Q, Brodaty H, Trollor J, Kochan N, Lobo A, Santabárbara J, Gracia-Garcia P, Sachdev PS, and Deckers K
- Subjects
- Humans, Male, Female, Risk Factors, Aged, Prospective Studies, Incidence, Dementia epidemiology, Life Style
- Abstract
Introduction: The LIfestyle for BRAin Health (LIBRA) index yields a dementia risk score based on modifiable lifestyle factors and is validated in Western samples. We investigated whether the association between LIBRA scores and incident dementia is moderated by geographical location or sociodemographic characteristics., Methods: We combined data from 21 prospective cohorts across six continents (N = 31,680) and conducted cohort-specific Cox proportional hazard regression analyses in a two-step individual participant data meta-analysis., Results: A one-standard-deviation increase in LIBRA score was associated with a 21% higher risk for dementia. The association was stronger for Asian cohorts compared to European cohorts, and for individuals aged ≤75 years (vs older), though only within the first 5 years of follow-up. No interactions with sex, education, or socioeconomic position were observed., Discussion: Modifiable risk and protective factors appear relevant for dementia risk reduction across diverse geographical and sociodemographic groups., Highlights: A two-step individual participant data meta-analysis was conducted. This was done at a global scale using data from 21 ethno-regionally diverse cohorts. The association between a modifiable dementia risk score and dementia was examined. The association was modified by geographical region and age at baseline. Yet, modifiable dementia risk and protective factors appear relevant in all investigated groups and regions., (© 2024 The Authors. Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.)
- Published
- 2024
- Full Text
- View/download PDF
33. [Ticagrelor monotherapy in patients with acute coronary syndrome receiving new generation drug-eluting stents: results of the T-PASS randomized clinical trial].
- Author
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Ruggiero R, Beneduce A, Demola P, Pompei G, Barioli A, Ryan N, Barbato E, and Toselli M
- Subjects
- Humans, Purinergic P2Y Receptor Antagonists administration & dosage, Purinergic P2Y Receptor Antagonists therapeutic use, Treatment Outcome, Male, Middle Aged, Platelet Aggregation Inhibitors administration & dosage, Platelet Aggregation Inhibitors therapeutic use, Female, Drug-Eluting Stents, Acute Coronary Syndrome therapy, Acute Coronary Syndrome drug therapy, Ticagrelor administration & dosage, Ticagrelor therapeutic use
- Published
- 2024
- Full Text
- View/download PDF
34. ["Extreme sports" in patients with heart disease: an informative approach to patient counseling].
- Author
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Feletti F and Savonitto S
- Subjects
- Humans, Male, Counseling, Female, Heart Diseases, Sports
- Abstract
The term "extreme sports" includes a range of sporting activities, predominantly individual, practised outdoors in a wild and non-competitive environment, which have in common the critical role of environmental variables, the importance of qualitative parameters in evaluating performance, the centrality of technological elements and the high perceived risk which, together with the spectacularity, attracts the attention of the media, favoring its popularity. Despite their diversity, these disciplines share specific risks and physiological and pathophysiological aspects. The average age of participants is generally higher than that of traditional and competitive sports, and the prevalence of male subjects implies a higher likelihood of cardiological evaluation whose path has yet to be codified like that of traditional sports. The risk of severe injuries in these sports is not higher than that of traditional sports and non-sporting activities. In contrast, the risk of cardiovascular events is documented only for some sports practised in the mountains, such as mountaineering, skiing and mountain biking, and it does not appear to be higher than that of equivalent physical activities performed at low altitudes. The diagnostic and prognostic criteria for cardiological counseling of enthusiasts are not defined. Environmental exposure to extremes of temperature, altitude, wind and humidity, and dehydration are typical characteristics of these activities, which should be addressed with adequate experience, preparation and equipment to minimize the potential impact on health. Finally, many of these activities are often conducted in "remote areas" compared to the possibility of emergency response, which should be considered in the risk assessment of an acute cardiovascular event. The definition of cardiovascular risk constitutes an open area of research to allow the practice of these sports to an increasing number of participants.
- Published
- 2024
- Full Text
- View/download PDF
35. [Giant coronary aneurysm incidentally detected on transthoracic echocardiography in a patient with previous Bentall procedure].
- Author
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Briani F, Dotto A, and Mugnolo A
- Subjects
- Humans, Male, Aortic Dissection surgery, Aortic Dissection diagnostic imaging, Aged, Computed Tomography Angiography methods, Incidental Findings, Coronary Aneurysm surgery, Coronary Aneurysm diagnostic imaging, Echocardiography methods
- Abstract
Coronary artery aneurysms represent a rare pathology (0.2-4.9% of patients undergoing coronary angiography) that may reach considerable size. The clinical presentation is various, manifesting as acute coronary syndrome or, conversely, remaining silent lifelong. We here report the case of an incidental finding by transthoracic echocardiography of a paracardiac mass of considerable size in a patient with vasculopathy that underwent a Bentall procedure for acute aortic dissection 18 years earlier. On thoracic computed tomography angiography, a 62 mm-sized giant aneurysm located in the proximal right coronary artery was evidenced. The optimal treatment of patients affected by coronary artery aneurysms remains debated; therefore, the therapeutic strategy should be individualized considering the etiology, clinical presentation, anatomical characteristics and concomitant presence of obstructive coronary artery disease.
- Published
- 2024
- Full Text
- View/download PDF
36. [Surgical treatment of coronary artery to pulmonary artery fistula with a saccular aneurysm].
- Author
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Musuraca G, Giovanelli C, Terraneo C, Osti N, Motta A, Angheben C, and Albiero R
- Subjects
- Humans, Male, Middle Aged, Coronary Artery Bypass methods, Coronary Angiography, Pulmonary Artery surgery, Pulmonary Artery diagnostic imaging, Arterio-Arterial Fistula surgery, Arterio-Arterial Fistula complications, Coronary Aneurysm surgery, Coronary Aneurysm complications, Coronary Aneurysm diagnostic imaging
- Abstract
A 60-year-old man with hypercholesterolemia and hypertension presented with acute coronary syndrome (SCA). The ECG showed lateral ischemia (T-wave inversion in V4-V6, D1 and aVL) and echocardiography showed normal left ventricular wall motion. Coronary angiography showed critical atherosclerotic lesions in the distal part of the left circumflex artery (LCx, culprit lesion), chronic total occlusion of the right coronary artery (RCA), significant but not critical stenosis in the middle part of left anterior descending artery (LAD), and a coronary artery to pulmonary artery (PA) fistula originating from the proximal part of the LAD and emptying into the PA via a coronary saccular aneurysm (12 x 12 x 10 mm). A multidetector row computed tomography angiography (CTA) confirmed the coronary artery fistula, which was treated with surgical approach. The patient underwent aneurysmorrhaphy with CAF closure and coronary artery bypass grafting on the RCA and LCx. The postoperative course was uneventful and the patient was discharged on postoperative day 14. CTA was useful for understanding the spatial relation of the CAF and the connection with the PA.
- Published
- 2024
- Full Text
- View/download PDF
37. [Mortality in an Italian factory producing tetraethyl lead].
- Author
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Micciolo R, Cristofolini A, Orrico D, Piffer S, Rizzello R, Terracini B, and Carra G
- Subjects
- Humans, Italy epidemiology, Male, Middle Aged, Adult, Lead Poisoning mortality, Occupational Exposure adverse effects, Occupational Diseases mortality
- Abstract
The Società Lavorazioni Organiche Inorganiche (SLOI) in Trento (North-Eastern Italy) produced tetraethyl lead from 1941 to 1978, when it was closed following an explosion, luckily with no fatalities. Working conditions were very bad. During the 1960s, 325 acute lead intoxications were reported and over 100 workers were hospitalized for neurological conditions attributable to tetraethyl lead. At least 12 SLOI workers were hospitalized in the mental asylum (psychiatric wards).The present work describes the first formal epidemiological study ever carried out on SLOI workers. In the absence of any original SLOI employee registers, a list of 1,742 workers hired since factory startup was assembled using the files of the Italian National Social Security Agency (digitalized in 1974 and perused manually by one of the Authors for the previous period). To date, follow-up for mortality has been completed for the 580 male employees at work in 1961 or hired subsequently and who worked at SLOI for at least 12 months. Twenty-two (3.8%) were lost to follow-up. Mortality in this sub-cohort was compared with that of the population of the province of Trento, gathered since 1986 by the Institute of Statistics of the Trento Province. Excluding deaths occurring at age 90+ years, during the 1986-2016 period, deaths in the SLOI sub-cohort were 295 vs 229.0 deaths expected from age- and period-specific rates in the reference population (standardazied mortality ratio 1.29; 95%CI 1.15-1.44). In the absence of individual data, the possible contribution to the mortality excess by non-occupational risk factors cannot be estimated. Identification of causes of death is underway.
- Published
- 2024
- Full Text
- View/download PDF
38. [The treatment path of transgender and gender diverse (TGD) minors and the impact of medical-surgical treatments on their mental health.]
- Author
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Pessina R, Di Giacomo E, and Clerici M
- Subjects
- Humans, Adolescent, Male, Female, Child, Minors psychology, Gender Identity, Health Services Accessibility, Standard of Care, Sex Reassignment Procedures, Transgender Persons psychology, Mental Health
- Abstract
Aim: The Standards of Care (SOC-8) by the World Professional Association for Trans Health provide guidelines for the care of transgender and gender diverse individuals through safe and effective multi-professional interventions for physical and mental well-being. The aim of this work is to summarize the SOC-8 recommendations for childhood and adolescence, highlighting the importance of psychosocial assessment and available medical and surgical therapeutic options, and emphasizing the need for healthcare provider training., Methods: The SOC-8 recommendations are based on scientific evidence and professional consensus from experts in transgender health, developing classification criteria and access to therapies, based on systematic literature reviews (PubMed and Embase)., Results: The SOC-8 underscores the importance of assessing and preserving gender identity, supporting prepubescent individuals from a psychosocial perspective, and ensuring adolescents access to medically and surgically conforming treatments according to local legislation. It is the responsibility of healthcare providers to understand and adapt international guidelines for an inclusive clinical practice of gender diversity., Discussion and Conclusions: Gender affirmation therapies in minors require comprehensive evaluation, parental involvement, and consideration of their cognitive and emotional maturity. Treatments should also focus on preserving fertility and accessing medicalized treatments which are beneficial to the well-being of transgender and gender diverse individuals.
- Published
- 2024
- Full Text
- View/download PDF
39. [BLITZ-AF Cancer study: an international observational research project on patients with atrial fibrillation and cancer].
- Author
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Gulizia MM, Turazza FM, Ameri P, Alings M, Collins R, De Luca L, Di Nisio M, Lucci D, Gabrielli D, Janssens S, Parrini I, Pinto FJ, Zamorano JL, and Colivicchi F
- Subjects
- Male, Humans, Female, Aged, Aged, 80 and over, Fibrinolytic Agents therapeutic use, Prospective Studies, Anticoagulants, Risk Factors, Atrial Fibrillation complications, Atrial Fibrillation drug therapy, Atrial Fibrillation diagnosis, Neoplasms complications, Stroke complications
- Abstract
Background: Cancer is an important condition associated with the development of atrial fibrillation (AF). The objectives of the BLITZ-AF Cancer study were to collect real-life information on the clinical profile and use of antithrombotic drugs in patients with AF and cancer to improve clinical management, as well as the evaluation of the association between different antithrombotic treatments (or their absence) and the main clinical events., Methods: European multinational, multicenter, prospective, non-interventional study conducted in patients with AF (electrocardiographically confirmed) and cancer occurring within 3 years. The CHA2DS2-VASc and the HAS-BLED scores were calculated in all enrolled patients., Results: From June 2019 to July 2021, 1514 patients were enrolled, 36.5% women, from 112 cardiology departments in 6 European countries (Italy, Belgium, the Netherlands, Spain, Portugal and Ireland). Italy enrolled 971 patients in 77 centers. Average age of patients was 74 ± 9 years, of which 20.9% affected by heart failure, 18.1% by ischemic heart disease, 9.8% by peripheral arterial disease and 38.5% by valvular diseases; 41.5% of patients had a CHA2DS2-VASc score ≥4. The most represented cancer sites were lung (14.9%), colorectal tract (14.1%), prostate (8.8%), or non-Hodgkin's lymphoma (8.1%). Before enrollment, 16.6% of patients were not taking antithrombotic therapy, while 22.7% were on therapy with antiplatelet agents and/or low molecular weight heparin. After enrollment these percentages decreased to 7.7% and 16.6%, respectively and, at the same time, the percentage of patients on direct oral anticoagulant (DOAC) therapy increased from 48.4% to 68.4%, also to the detriment of those on vitamin K antagonist therapy., Conclusions: The BLITZ-AF Cancer study, which enrolled patients diagnosed with AF and cancer, highlights that the use of DOACs by cardiologists in this clinical context has increased, even though the guidelines on AF do not give accurate indications about oral anticoagulant therapy in patients with cancer.
- Published
- 2024
- Full Text
- View/download PDF
40. [Temporal analysis of the prevalence of congenital hypospadias in the municipality of Gela].
- Author
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Tavormina EE, Bianchi F, Drago G, Ruggieri S, Usticano A, Cernigliaro A, Scondotto S, Pollina Addario S, Cosentini I, and Cibella F
- Subjects
- Humans, Prevalence, Male, Sicily epidemiology, Infant, Infant, Newborn, Italy epidemiology, Oil and Gas Industry, Environmental Exposure adverse effects, Risk Factors, Odds Ratio, Hypospadias epidemiology
- Abstract
Objectives: to evaluate the risk profile of hypospadias in Gela, an Italian National Priority Contaminated Site (NPCS) located in Sicily Region (Southern Italy), characterized by a significant excess of hypospadias in newborn residents compared to data from reference on regional, national, and international basis and, until 2014, by the presence of a petrochemical plant., Design: geographical analyses were conducted by comparing the prevalence of the Gela municipality to prevalence found in Sicily, in a territorial area bordering Gela (ALG), and in the NPCSs of Milazzo and Priolo. The geographical comparisons were conducted for the period 2010-2020, the trend within the Gela NPCS was evaluated by comparing two subperiods (2010-2014 and 2015-2020)., Setting and Participants: children up to 1 year of age with hypospadias resident in the municipality of Gela in the period 2010-2020., Main Outcomes Measures: crude odds ratios (OR) and respective 95% confidence intervals (95%CI) were used to compare the prevalence observed in Gela and that detected in the comparison areas., Results: excess risk for hypospadias was highlighted in 2010-2020 in Gela vs Sicily (OR 4.45; 95%CI 3.45-5.75), vs ALG (OR 4.29; 95%CI 3.02-6.10), and vs the NPCSs of Milazzo (OR 2.32; 95%CI 1.32-4.07) and Priolo (OR 2.37; 95%CI 1.55-3.62). The between-period comparisons in Gela did not show an important difference between 2010-2014 and 2015-2020 (OR 1.37; 95%CI 0.83-2.24), with a prevalence of 98.9 and 72.4 per 10,000, respectively., Conclusions: the prevalence of hypospadias in 2015-2020 remains very high, although decreasing when compared to 2010-2014 period. The Gela data, despite the refinery being closed after 2014, suggest a complex situation in which multiple risk factors may play a role.
- Published
- 2024
- Full Text
- View/download PDF
41. [Concurrent simultaneous integrated boost radiotherapy and cetuximab in head and neck squamous cell cancer patients: is it feasible in daily clinical practice?]
- Author
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Chillari F, Parisi S, Ferrantelli G, Carrubba C, Santacaterina A, Critelli P, Sciacca M, Venuti V, Lillo S, Cacciola A, Iatì G, Pontoriero A, Platania A, Delia P, Tombolini V, De Felice F, Musio D, Spatola C, Brogna A, and Pergolizzi S
- Subjects
- Humans, Male, Female, Middle Aged, Aged, Italy, Survival Rate, Adult, Treatment Outcome, Neoplasm Staging, Aged, 80 and over, Carcinoma, Squamous Cell pathology, Carcinoma, Squamous Cell therapy, Carcinoma, Squamous Cell radiotherapy, Carcinoma, Squamous Cell drug therapy, Retrospective Studies, Cetuximab administration & dosage, Head and Neck Neoplasms radiotherapy, Head and Neck Neoplasms pathology, Head and Neck Neoplasms therapy, Head and Neck Neoplasms drug therapy, Squamous Cell Carcinoma of Head and Neck radiotherapy, Squamous Cell Carcinoma of Head and Neck therapy, Squamous Cell Carcinoma of Head and Neck drug therapy, Squamous Cell Carcinoma of Head and Neck pathology, Chemoradiotherapy methods, Antineoplastic Agents, Immunological administration & dosage, Radiotherapy, Intensity-Modulated methods, Radiotherapy, Intensity-Modulated adverse effects
- Abstract
Introduction and Aim: Locally advanced head and neck squamous cell carcinoma (LA-Hnscc) is a true therapeutical challenge in the modern era and the scientific community is trying to face this challenge with new therapeutical strategies, including combinations of monoclonal antibodies and radiation therapy. The aim of this study is to evaluate clinical outcomes in LA-Hnscc patients unfit to receive platinum-based chemotherapy, treated with concurrent simultaneous integrated boost-intensity modulated radiotherapy (Sib-Imrt) + cetuximab (Ctx) in daily clinical practice., Methods: LA-Hnscc patients not included in other prospective studies treated in 4 Italian radiotherapy units (2 Messina, 1 Rome, and 1 Lecce) using Sib-Imrt and Ctx were included in this study. Acute and late toxicities and overall survival (OS) have been evaluated., Results: Data regarding 27 patients with squamous tumour were collected and reviewed. The primary tumour sites were oropharynx in 14 patients (51.9%), oral cavity in 7 (25.9%), larynx in 3 (11%) and other sites in 3(11%). There were 20 (74%) patients had stage IV (16 IVa and 4 IVb). Complete remission was observed in 18 patients (66.7%), a partial remission in 4 (14.8%) whilst 4 had a progression disease (14.8%). After 3 year of follow-up 7/27 patients were deaths. The OS was 95.5%, 62.5% and 52.9% respectively at 1,2 and 3 years. Acute toxicities were observed in all treated patients (mucositis, dermatitis and dysphagia) while 66.7% of patients developed late toxicities. All observed toxicities were grade 1 to 3 and just 1 patient developed a G4 toxicity., Conclusion: The concurrent bio-radiotherapy of Sib-Imrt and cetuximab is feasible in real-life daily clinical practice for LA-Hnscc patients unfit for platinum-based chemoradiotherapy.
- Published
- 2024
- Full Text
- View/download PDF
42. [Effects of insecticides on sperm concentration: a new systematic review calls for more prevention].
- Author
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Mandrioli D and Sgargi D
- Subjects
- Humans, Male, Spermatozoa drug effects, Systematic Reviews as Topic, Insecticides, Sperm Count
- Published
- 2024
- Full Text
- View/download PDF
43. [What patients with cancer think about the dehospitalization. A survey of Cipomo.]
- Author
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Barni S, Aschele C, Blasi L, Giordano M, Ortega C, Pinotti G, Artioli F, Fioretto L, Daniele B, Aprile G, Silva RR, and Montesarchio V
- Subjects
- Humans, Italy, Surveys and Questionnaires, Male, Middle Aged, Female, Aged, Adult, Aged, 80 and over, Hospitals, Public, Hospitalization statistics & numerical data, Neoplasms drug therapy, Neoplasms therapy
- Abstract
Background: Ministerial Decrete 77 (DM 77) promotes dehospitalization for chronic patients and defines out-of-hospital health facilities at this purpose. It has never been investigated how much patients with cancer know and judge this decree law., Material and Methods: The Collegio italiano dei primari oncologi medici ospedalieri (Cipomo) carried out a survey with a dedicated questionnaire on oncological patients attending public hospital to investigate the liking of DM 77., Results: Anonymous responses were obtained from 1.443 patients. Median age 64ys, 42% males, 21% live alone, 70% have a companion. 19% thinks that oral chemotherapy could be managed outside the hospital, 26.68% carried out follow-up (FU),19.15% parenteral therapy, 32.16% basic examinations. Home is preferred by 21.8%, a health facility close to home by 36.3%, hospital by 37.54%. 59.67% would like FU in hospital by their personal oncologist, 5.47% by GP, 35.41% by both together and 9.45% by oncologist outside the hospital. Asked what they might feel about being followed out of the hospital, 29.94% say of not being treated at its best, 12.68% of not being able to be visited in hospital anymore, 5.27% of being abandoned, 30.7% of being freer and 10.88% of feeling less sick. Regarding the use of new technical tools to favor dehospitalisation, 44.15% answered yes, 15.88% no and 30.07% did not know. About the distance or traveling time from home to the therapy administration side, 20.26% answered this should be no more than 15 km or 30 mins, 9.91% no more than 30 km or 45 mins, 5.47% no more than 50 km or 60 mins but 39.5% say that the distance does not matter to them but only the continuity of care. The question related to the inconveniences with going to hospital for therapy: 40.81% waiting time, 20.47% lack of parking, 17.02% rotation of doctors,12.76% travel time and 5.62% bureaucracy., Conclusions: The patients' answers suggest that dehospitalization could improve their quality of life, but at the condition of being able to maintain a close relationship with the personal oncologist.
- Published
- 2024
- Full Text
- View/download PDF
44. Longitudinal cerebral perfusion in presymptomatic genetic frontotemporal dementia: GENFI results.
- Author
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Pasternak M, Mirza SS, Luciw N, Mutsaerts HJMM, Petr J, Thomas D, Cash D, Bocchetta M, Tartaglia MC, Mitchell SB, Black SE, Freedman M, Tang-Wai D, Rogaeva E, Russell LL, Bouzigues A, van Swieten JC, Jiskoot LC, Seelaar H, Laforce R Jr, Tiraboschi P, Borroni B, Galimberti D, Rowe JB, Graff C, Finger E, Sorbi S, de Mendonça A, Butler C, Gerhard A, Sanchez-Valle R, Moreno F, Synofzik M, Vandenberghe R, Ducharme S, Levin J, Otto M, Santana I, Strafella AP, MacIntosh BJ, Rohrer JD, and Masellis M
- Subjects
- Humans, Female, Male, Middle Aged, Longitudinal Studies, Gray Matter diagnostic imaging, Gray Matter pathology, Progranulins genetics, Biomarkers, Disease Progression, Brain diagnostic imaging, Heterozygote, Mutation, Aged, Spin Labels, Adult, Frontotemporal Dementia genetics, Frontotemporal Dementia physiopathology, Frontotemporal Dementia diagnostic imaging, Magnetic Resonance Imaging, Cerebrovascular Circulation physiology, Cerebrovascular Circulation genetics, C9orf72 Protein genetics, tau Proteins genetics
- Abstract
Introduction: Effective longitudinal biomarkers that track disease progression are needed to characterize the presymptomatic phase of genetic frontotemporal dementia (FTD). We investigate the utility of cerebral perfusion as one such biomarker in presymptomatic FTD mutation carriers., Methods: We investigated longitudinal profiles of cerebral perfusion using arterial spin labeling magnetic resonance imaging in 42 C9orf72, 70 GRN, and 31 MAPT presymptomatic carriers and 158 non-carrier controls. Linear mixed effects models assessed perfusion up to 5 years after baseline assessment., Results: Perfusion decline was evident in all three presymptomatic groups in global gray matter. Each group also featured its own regional pattern of hypoperfusion over time, with the left thalamus common to all groups. Frontal lobe regions featured lower perfusion in those who symptomatically converted versus asymptomatic carriers past their expected age of disease onset., Discussion: Cerebral perfusion is a potential biomarker for assessing genetic FTD and its genetic subgroups prior to symptom onset., Highlights: Gray matter perfusion declines in at-risk genetic frontotemporal dementia (FTD). Regional perfusion decline differs between at-risk genetic FTD subgroups . Hypoperfusion in the left thalamus is common across all presymptomatic groups. Converters exhibit greater right frontal hypoperfusion than non-converters past their expected conversion date. Cerebral hypoperfusion is a potential early biomarker of genetic FTD., (© 2024 The Authors. Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.)
- Published
- 2024
- Full Text
- View/download PDF
45. [Cuff Shaving in Recurrent Exit-Site Infections in a Patient on Peritoneal Dialysis].
- Author
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Cosentini V, Rognini S, Giannella Mantovani L, Zennari L, Hasheminia A, Dal Dosso I, and Gammaro L
- Subjects
- Humans, Peritonitis microbiology, Peritonitis etiology, Male, Peritoneal Dialysis adverse effects, Peritoneal Dialysis instrumentation, Catheter-Related Infections microbiology, Catheter-Related Infections prevention & control, Catheter-Related Infections etiology, Catheters, Indwelling adverse effects, Catheters, Indwelling microbiology, Recurrence
- Abstract
In patients on peritoneal dialysis, the cutaneous emergency (exit-site) represents a potential access route to the peritoneum; consequently, it can become a site for microbial infections. These infections, initially localized to the exit-site, may spread to the peritoneum causing peritonitis, which is the most common cause of drop-out from peritoneal dialysis and transition to hemodialysis. Peritoneal catheters have dacron caps which have the function of counteracting the traction of the catheter itself and at the same time acting as a barrier for microorganisms, preventing the spread towards the peritoneum. Despite this, the same dacron cap can represent a sort of nest for microorganisms to colonize and, with the formation of a biofilm that facilitates their proliferation, make the same organisms impervious to antibiotic therapy and even resistance to them. The most effective tool for monitoring the health status of the exit-site is represented by the objective examination. This examination, through the use of well-defined scales, helps to provide a pathological score of the exit, facilitating the implementation of necessary precautions. In the presence of recurrent exit-site infections, from both Gram positive and Gram negative bacteria, minimally invasive surgical therapy is a valid approach to break this vicious circle. It helps avoid subjecting the patient to the removal of the peritoneal catheter, temporary transition to hemodialysis with the insertion of a central venous catheter, and subsequent repositioning of another peritoneal catheter. We propose the case of a recurrent Staphylococcus Aureus infection resolved after cuff shaving of the exit-site., (Copyright by Società Italiana di Nefrologia SIN, Rome,Italy.)
- Published
- 2024
46. [Executive Dysfunction in Patients Undergoing Chronic Haemodialysis Treatment: A Possible Symptom of Vascular Dementia].
- Author
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Belluardo G, Galeano D, Sessa C, Zanoli L, and Morale W
- Subjects
- Humans, Aged, Female, Male, Middle Aged, Risk Factors, Anemia etiology, Hypertension etiology, Renal Dialysis adverse effects, Executive Function, Dementia, Vascular etiology
- Abstract
Introduction. Patients undergoing chronic haemodialysis (HD) treatment have an 8-10 times higher risk of experiencing stroke events and developing cognitive impairment. The high vascular stress they are subjected to may be the basis for the development of vascular dementia (VaD). Objective. The aim of the study is to investigate the executive functions, typically impaired in VaD, of patients undergoing chronic haemodialysis treatment. Method. HD patients were recruited from the U.O.C. of Nephrology and Dialysis (ASP Ragusa). Risk factors for VaD were collected and then the Frontal Assessment Battery (FAB) was administered. Results. 103 HD patients were included (males = 63%, age 66 ± 14 years). Risk factors for VaD included a high percentage of patients with anaemia (93%), hypertension (64%) and coronary artery disease (68%). The cognitive data obtained via FAB show a percentage of 55% deficit scores. All risk factors found a significant association with cognitive scores. Anemia, hypertension, intradialytic hypotension, coronary artery disease, and homocysteine are negative predictors of executive function integrity. Conclusions. More than half of the patients had deficit scores on the FAB. Reduced cognitive flexibility, high sensitivity to interference, poor inhibitory control and impaired motor programming with the dominant hand were evident. In conclusion, a marked impairment of the executive functions, generally located in the frontal lobes of the brain, was detected in the HD patient, which could be a symptom of a dementia of a vascular nature., (Copyright by Società Italiana di Nefrologia SIN, Rome,Italy.)
- Published
- 2024
47. [Process nurse: the experience of the Emergency Department of Fano].
- Author
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Belardinelli M, Ricci M, Frassini S, Ventura D, and Rasori S
- Subjects
- Humans, Pilot Projects, Male, Female, Italy, Middle Aged, Adult, Crowding, Emergency Nursing, Patient Dropouts statistics & numerical data, Emergency Service, Hospital, Triage, Length of Stay
- Abstract
. Process nurse: the experience of the Emergency Department of Fano., Introduction: Overcrowding in Emergency Departments (ED) is a common worldwide phenomenon. Strategies are needed to manage the excessive influx and length of stay in the Accidents and Emergency (A&E) ward, which may adversely affect the organization of care. The process nurse (PN) has been proposed, but the literature lacks rigorous studies on its effectiveness., Purpose: The pilot study was conducted to evaluate how the PN affects thre length of stay and drop-out rate after triage of selected users accessing the A&E., Methods: The PN was introduced in the A&E of the Santa Croce Hospital in Fano-AST Pesaro Urbino. Users with codes 3, 4, 5 and the most frequent causes for A&E visits were included. The length of stay and drop-out rate after triage were compared between users assigned to the PN and those who, at the same time and with the same problem and access codes, followed the standard process., Results: In November 2022, 943 users were enrolled, 214 cared by the PN and 729 with standard care. The mean time spent in the A&E was significantly lower in the PN group (206.7 ± SD 144.2 minutes vs 282.4 ± SD 208.9 minutes, p <0.0001). The discharge rate was higher in the PN group (89.7% vs 75.3% p <0.0001), while the drop-out rate was lower (9.8% vs 24.1% p <0.0001)., Conclusions: The results highlight the potentialities of PN in the A&E and at triage, emphasizing its ability to speed up, facilitate, and optimize care pathways.
- Published
- 2024
- Full Text
- View/download PDF
48. [The declining power of the human touch in the digital world.]
- Author
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Collecchia G
- Subjects
- Humans, Female, Male, Physician-Patient Relations, Empathy, Hand, Touch, COVID-19
- Abstract
Humans are social creatures, and touch is the most primitive form of relationship. In the context of the traditional medical examination, touch, palpation, is essential to diagnose or suspect pathology. But it is not only an issue of semeiotics. The physician's ability to examine a body through his or her hands is at the heart of the doctor-patient relationship. Moreover, we have been witnessing for many years to the progressive downgrading of the objective examination in clinical practice. First, the obsolescence of interaction with the patient due to the lure of diagnostic technology, then the "social distancing" of Covid-19 and, finally, the expansion of telemedicine has contributed to the distancing of caregivers from patients. The same technology that tends to distance doctor and patient provides haptic wearable devices that can digitize touch and open up application scenarios that are still largely unexplored. These, however, cannot replace human interaction. What can we do to preserve the culture of physical contact in the doctor-patient relationship? As always, awareness is the first step. The technology that separates us from patients is not the real problem. It is only when it becomes an end instead of a means that we risk losing centuries of medical tradition. It is therefore necessary to strike a balance between using technology and ensuring that health care professionals maintain a central role in providing emotional support and understanding to patients. Such issues should be introduced early in the medical student's training. In the course of study, not only the mechanisms of disease should be taught, but also how to approach care with compassion, empathy and "human touch". In any case, even if digital culture eventually prevails, it is necessary to practice at least "touch" as interpersonal sensitivity, gentleness, and the ability to intercept the other's state of mind and respect it.
- Published
- 2024
- Full Text
- View/download PDF
49. Utjecaj rodne ideologije na ekologiju čovjekove spolne naravi. Kršćansko-teološko antropološki osvrt
- Author
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Marijo Volarević
- Subjects
ecology ,gender ideology ,gender ,sex ,nature ,male ,female ,family ,Christian anthropology ,Philosophy. Psychology. Religion - Abstract
The author tries to show how today man becomes more and more aware not only of the endangerment of man’s environment but of the endangerment of man’s innate sexual nature, as well. Man, created in the image of God as male and female (cf. Gen 1:26-27), is called not only to act responsibly towards the created reality God has given him, but also towards the image of God that is mirrored in him, equally in man and woman. In the same way that through history man hasn’t been responsibly governing the created world, of which he is a guardian and not a master, in a similar way today, with the help of gender ideology, he wants to dominate over the sexual nature that was gifted to him. With the article the author seeks to warn, in accordance with Christian-biblical-theological anthropology, about the fundamental defects of gender ideology which through theoretical technicism penetrates the very essence of man’s sexual nature, thus directly affecting the ecology of human nature and the ecology of family.
- Published
- 2019
- Full Text
- View/download PDF
50. Una struggente nostalgia dell’intero. La tentazione dell’androgino come ricomposizione dell’umano
- Author
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Emanuela Susca
- Subjects
Androgyny ,Female ,Gender ,Love ,Male ,Fine Arts ,Arts in general ,NX1-820 ,Social sciences (General) ,H1-99 - Abstract
At the end of the nineteenth century, Giddens proposed a new kind of androgyny intended as a way to resolve the conflict between the sexes and democratise societies starting from the most intimate area of our lives. In so doing, mainstream sociology made use of an ancient idea that is central in a set of founding myths with reference both to the West and to the rest of the world and is subsequently visible in several literary works, artistic creations and cultural trends. All these elements, in fact, reveal at least two aspects: firstly, human beings unconsciously think themselves as painfully ruptured creatures and therefore tend to some kind of completion; secondly, androgyny can represent both a way to criticize old sexual stereotypes and a more general attempt to differently think and live. This is particularly true nowadays, when so-called postmodernity seems to yearn for androgyny intended as lightness of thought and life but also as illusory and narcissistic self- sufficiency.
- Published
- 2019
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