Search

Objective Antiphospholipid syndrome (APS) is characterised by increased cardiovascular morbidity and mortality, related to thrombo-inflammatory and atherogenic mechanisms. We examined the achievement of traditional cardiovascular risk factor (CVRF) therapeutic goals in APS versus other high cardiovascular risk disorders such as rheumatoid arthritis (RA) and diabetes mellitus (DM), and trends over time. Methods 122 patients with APS (74 primary APS, female 68%, mean age 44.5±11.3) were classified according to their first visit (2011-2015 and 2016-2020 APS subgroups, 61 patients in each subgroup) and matched 1:1 for age/sex with patients with RA and DM. Cardiovascular risk was estimated by the Systemic Coronary Risk Evaluation, and the CVRF therapeutic targets were defined according to the European Society of Cardiology (ESC) guidelines. Individual and multiple CVRF control was compared between APS subgroups, and in APS versus RA and DM. Results We found a comparable or higher prevalence of CVRFs between APS and age-matched/sex-matched patients with RA and DM but low CVRF target attainment in APS according to the ESC guidelines. Despite improving trends between 2011-2015 and 2016-2020, CVRF control in high/very high-risk patients with APS was 12%, 18%, 24% and 35% for low-density lipoprotein, waist circumference, exercise and body mass index, respectively, and 59%-65% for triglycerides, high-density lipoprotein (HDL) and blood pressure, in 2016-2020 subgroup. CVRF control was worse in APS versus RA for smoking (p=0.014), HDL (p

We present the preliminary results of the modern distribution of the benthic foraminifera in the Channel of Sicily (off Gela, 200-1000m w.d.) and in Malta escarpment (200-3000m w.d.). These areas are investigated within EC project HERMES to verify the possible impact on the biodiversity of two recent slope failures (the NW slides characterised by pressure ridges and the SE slides by blocks). The study of the slope failures was carried out with a multidisciplinary approach as seismic stratigraphy and sediment cores were available. The stratigraphic record of the cores (based on foraminifera micropaleontology, lithology, isotope stratigraphy, radiocarbon datings as well as magnetic properties) suggests that the age of the most recent failures is younger than 3.5 kyrs B.P. The foraminifera study has been carried out on samples collected by means of a box corer, subsequently subsampled with short tubes (or liners) to obtain sediment samples 0.5/1cm thick for the uppermost part. The sediment samples were treated with Bengal Rose to detect the living (=stained) assemblage, then results are presented as living and total (living + dead foraminifera) assemblage. Moreover, CTD data are available for each investigated site as well as the oxygen profile in the first centimetres of the sediment of the box cores. The preliminary results of this study are here summarised: 1) strong differences are present between samples collected in the slide scars (e.g. no living specimens and general bad preservation state of the microfauna in the SE slide scar), 2) the distal areas of the two slides present assemblage similar to the ones of the samples collected off the slides areas (samples assumed not affected by the failures and then representative of "normal" condition), 3) in general the samples of the NW slides are quite similar to the ones off the slide, 4) the samples of the SE slides are dominated by organically cemented agglutinants (in particular high abundance of tubular agglutinant specie) in the living as well as in the total assemblage, 5) in both the areas (Gela and Malta) infaunal forams such as Brizalina spp and Bulimina marginata are present only in the shallowest samples while oxic species, such as Cibicides spp/Cibicidoides spp and Buccella spp are present only in the deepest samples, and this is confirmed also by oxygen penetration depths in the sediment. These results seem to indicate that the SE slide represents an area somewhat still affected by sediment transport in comparison with the NW slide area. Acknowledgements: HERMES is an European Community funded project of the 6th Framework Programme. See http://www.eu-hermes.net

Calcareous nannofossil biostratigraphic studies are presented from 11 sedimentary sections, nine located in theMediterranean area and one each from the middle latitude North and South Atlantic, respecitively. The distribution patterns of middle to late Eocene calcareous nannofossils are studied by means of quantitative and semiquantitative methods. Our main goal was to test the biostratigraphic reproducibility of bioevents used in two classical standard biozonations, and to introduce new biostratigraphically useful biohorizons, resulting in a series of new middle latitude biostratigraphic events. The new zonal scheme substantially improves the available biochronologic resolution, doubling the current partioning based on the classical standard zonations. This study extends the terminal Eocene and Oligocene calcareous nannofossil zonal scheme proposed for the Mediterranean area (Catanzariti et al. 1997), into the middle Eocene. New age estimates are provided, which highligth the need to revise the present middle-late Eocene calcareous nannofossil biochronology. Two new species are described: Cribrocentrum erbae sp. nov. and Cribrocentrum isabellae sp. nov.

Background Crisis Resolution Home Treatment (CRHT) is an alternative to inpatient treatment for acute psychiatric crises management. However, evidence on CRHT effectiveness is still limited. In the Canton of Ticino (Southern Switzerland), in 2016 the regional public psychiatric hospital replaced one acute ward with a CRHT. The current study was designed within this evaluation setting to assess the effectiveness of CRHT compared to standard inpatient treatment. Methods CRHT was offered to patients aged 18 to 65 with an acute psychiatric crisis that would have required hospitalization. We used a natural experiment based on geography, where intervention and control groups were formed according to the place of residence. Primary endpoints were reduction of psychiatric symptoms at discharge measured using the Health of the Nation Outcome Scales, treatment duration in days, and rate and length of readmissions during a two-year follow-up period after discharge. Safety during the treatment period was measured with the number of serious adverse events (suicide/suicide attempts, major self-harm episodes, acute alcohol/drug intoxications, aggressions to caregivers or family members). We used linear, log-linear and logistic regression models with propensity scores for the main analysis. Results We enrolled 321 patients; 67 were excluded because the treatment period was too short and 17 because they were transferred before the end of the treatment. Two hundred thirty-seven patients were available for data analysis, 93 in the intervention group and 144 in the control group. No serious adverse event was observed during the treatment period in both groups. Reduction of psychiatric symptoms at discharge (p-value = 0.359), readmission rates (p-value = 0.563) and length of readmissions (p-value = 0.770) during the two-year follow-up period did not differ significantly between the two groups. Treatment duration was significantly higher in the treatment group (+ 29.6% on average, p-value = 0.002). Conclusions CRHT was comparable to standard hospitalization in terms of psychiatric symptoms reduction, readmission rates and length of readmissions, but it was also characterized by a longer first treatment period. However, observational evidence following the study indicated that CRHT duration constantly lowered over time since its introduction in 2016 and became comparable to hospitalization, showing therefore to be an effective alternative also in terms of treatment length. Trial registration ISRCTN38472626 (17/11/2020, retrospectively registered).