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Background: The COVID-19 outbreak has overwhelmed and altered health care systems worldwide, with a substantial impact on patients with chronic diseases. The response strategy has involved implementing measures like social distancing, and care delivery modalities like telemedicine have been promoted to reduce the risk of transmission.Objective: The aim of this study was to analyze the benefits of using telemedicine services for patients with chronic liver disease (CLD) at a tertiary care center in Italy during the COVID-19-mandated lockdown.Methods: From March 9 to May 3, 2020, a prospective observational study was conducted in the Liver Unit of the University Hospital of Naples Federico II to evaluate the impact of (1) a fully implemented telemedicine program, partially restructured in response to COVID-19 to include video consultations; (2) extended hours of operation for helpline services; and (3) smart-working from home to facilitate follow-up visits for patients with CLD while adhering to social distancing regulations.Results: During the lockdown in Italy, almost 400 visits were conducted using telemedicine; only patients requiring urgent care were admitted to a non-COVID-19 ward of our hospital. Telemedicine services were implemented not only for follow-up visits but also to screen patients prior to hospital admission and to provide urgent evaluations during complications. Of the nearly 1700 patients with CLD who attended a follow-up visit at our Liver Unit, none contracted COVID-19, and there was no need to alter treatment schedules.Conclusions: Telemedicine was a useful tool for following up patients with CLD and for reducing the impact of the COVID-19 pandemic. This system of health care delivery was appreciated by patients since it gave them the opportunity to be in contact with physicians while respecting social distancing rules. [ABSTRACT FROM AUTHOR]

EMODnet Geology is a European Project which promotes the collection and harmonization of existing marine geological data, in order to make them freely available through a web portal. One of the main objectives of the Project is the interoperability of data, in order to offer more complete, error-free and reliable information and to facilitate exchange and reuse of data even between non-homogeneous systems.Among the several features considered within the Project, "Geological events and probabilities", coordinated by the Geological Survey of Italy - ISPRA, include submarine landslides, earthquakes, volcanic centers, tsunamis, fluid emissions and Quaternary faults in European Seas. Datasets consist of shapefiles representing each kind of event (as polygons, lines and points layers according to their geometry). Due to the different geological settings of European sea areas it was necessary to elaborate a comprehensive and detailed pattern of Attributes for the different features in order to represent the diverse characteristics of each occurrence, particularly aimed at the harmonization and standardization complying with the European INSPIRE Directive.The systematic collection of Italian data, addressed at the EMODnet Geology Project, conducted to the compilation of the volume: "Atlas of Italian Submarine Volcanic Structures" (in press). The shaded relief model of the Italian seafloor and the relative contour lines used were obtained from the EMODnet Bathymetry portal (http://www.emodnet-bathymetry.eu/dataproducts). More detailed bathymetric maps were also available for some areas of the Tyrrhenian Sea and were used for morphological descriptions. A polygon shapefile represents the basal area of each seamount, whereas a point shapefile indicates the highest culmination above seafloor. The drawing of the basal contour line of each seamount was based on geological and physiographic boundaries. It was extended to the main break in slope of the inferred base; consequently the extent of the edifices derives from the volcanological interpretation of their morphology, significantly improving previous outlines. The shape and extent of the volcanic structures were also inferred from structural and geophysical map images extrapolated from published literature and georeferenced by means of a GIS software. Once defined the seamount area, the volume of the entire edifice was calculated using the reference Digital Elevation Model (DEM EMODnet).A total of 76 volcanic seamounts has been identified. Eighteen of these seamounts emerge above sea level as well-known volcanic islands, while three edifices are structures recognised as volcanic in nature from old studies, but previously un-named; so we have named them for the first time as Livia, Creusa and Tiro. The volcanic centers identified have been complemented by very detailed information. From a thorough literature search, including seismic lines from Oceanic Cruises, it was possible to collect and enter information related to different characteristics such as morphological and structural seabed maps, chemical composition of dredged samples, geophysical surveys, and additional information where available. [ABSTRACT FROM AUTHOR]

Objectives: Endoscopic submucosal dissection (ESD) is a minimally invasive technique for the resection of superficial gastrointestinal lesions, providing high rates of 'en bloc' and R0 resection. East-West differences in ESD quality indicators have been reported. This study aims to assess feasibility, effectiveness, and safety of ESD for the treatment of superficial gastrointestinal (GI) lesions in a Western cohort., Methods: Consecutive patients undergoing ESD at one Italian endoscopic referral center from September 2018 to March 2020 were included in this prospective study. Primary outcomes were technical success, R0 resection rate, curative resection rate, and adverse events (AEs)., Results: In total 111 patients (111 lesions) undergoing ESD were included. Anatomic site of the lesions was rectum in 56.8%, colon in 13.5%, stomach in 24.3%, and esophagus in 5.4% of cases, respectively. For upper GI procedures, technical success was 100%, and R0 and curative resection rates were 84.8% and 78.8%, respectively. For colorectal procedures, technical success was 98.7%, R0 and curative resection rates were 88.5% and 84.6%, respectively. Major AEs were reported in 12 cases (10.8%)., Conclusion: The introduction of ESD in a Tertiary Center is feasible, effective, and safe, and should be taken into consideration for the treatment of superficial GI lesions requiring 'en bloc' resection., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Up to 50% of patients with common variable immunodeficiency (CVID) present persistently increased serum levels of liver enzymes and/or mild hepatomegaly. Ultrasound-based transient elastography (TE) is largely used for early detection of the progression of chronic liver diseases, but has never been employed in CVID. We performed a cross-sectional study to evaluate TE values in a cohort of adult CVID-patients., Methods: Full blood count, liver function test, liver and spleen sonogram and ultrasound-based TE were performed in 77 adult CVID patients. Demographic and clinical data were retrospectively collected from medical files., Results: 33.8% (26/77) patients presented increased TE values ranging from moderate fibrosis to cirrhosis. TE values were positively correlated with ALP, γGT, spleen longitudinal diameter and peripheral blood counts (no significant correlation with BMI, AST, ALT, total proteins, albumin, bilirubin and hemoglobin). Moreover, liver stiffness was higher in patients with the clinical phenotypes polyclonal lymphoproliferation and enteropathy, and patients with both these complications had an increased risk (OR: 7.14) of presenting pathologic TE values compared with those without anyone of these., Conclusions: Transient elastography is a useful tool to be used alongside clinical and laboratory data to assess liver involvement in CVID., (Copyright © 2019. Published by Elsevier Ltd.)