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better reported functional and health outcomes.In patients with osteoarthritis, the Goal Attainment Scale instrument can be used to measure health outcomes at different time points and its content may be linked to ICF providing a unified language and conceptual scientific basis.Nell'articolo "Effetti sulla mortalità e morbilità nella popolazione residente nei pressi dell'inceneritore di Valmadrera (LC)" sono state inserite delle modifiche. A pagina 149 il paragrafo «La realizzazione di questo studio è stata possibile grazie a una collaborazione tra i Comuni interessati dall'impianto (Annone di Brianza, Civate, Galbiate, Lecco, Malgrate, Suello, Valmadrera), attraverso il consorzio SILEA Spa (gestore dell'impianto di incenerimento), l'Agenzia di Tutela della Salute della Brianza (ATS), l'Università di Torino come soggetto tecnico per la realizzazione dello studio epidemiologico e la società Tecno Habitat che ha realizzato la modellistica ambientale» è stato sostituito dal seguente testo «La realizzazione di questo studio è stata possibile grazie alla collaborazione tra l'Agenzia di tutela della salute della Brianza (ATS Brianza) e i Comuni interessati dall'impianto (Annone di Brianza, Civate, Galbiate, Lecco, Malgrate, Suello, Valmadrera), che attraverso il consorzio SILEA Spa (gestore dell'impianto di incenerimento), hanno incaricato l'Università di Torino come soggetto tecnico per la realizzazione dello studio epidemiologico e la società Tecno Habitat per la realizzazione della modellistica ambientale». Inoltre, sono state aggiornate le dichiarazioni dei conflitti d'interesse.
to assess the occurrence of potentially inappropriate prescribing (PIP) in residents of Tuscany nursing homes (NHs) and its variation before and after NH entry.
retrospective observational study using data from the Regional Administrative Database of Tuscany.
the study involved residents of 67 Tuscan NHs identified between 2011 and 2012. To estimate PIP prevalence before and after NH, a subset of 10 indicators of the Screening Tool of Older Person's Prescriptions (STOPP) criteria were selected.
prevalence of PIP.RESULTS considering 2,801 NH residents, the proportion of PIP ranged from 0.0% to 55.2% and from 0.0% to 33.9% before and after the NH admission, respectively. Overall, this study showed a decrease in the occurrence of PIP after the NH admission for most of the indicators, reaching statistical significance for indicator 3 (tricyclic antidepressants in combination with an opiate or calcium channel blockers), 7 (prescription of NSAIDs in heart failure patients), and 9 (warfarin in combination with NSAIDs).
although the reduction of PIP after NH admission may suggest greater awareness about the appropriateness of drug use, more efforts still need to be made.
although the reduction of PIP after NH admission may suggest greater awareness about the appropriateness of drug use, more efforts still need to be made.
immigrant women diagnosed with gestational diabetes mellitus (GDM) have additional language and cultural obstacles in following lifestyle and dietary recommendations within a Western health care setting.
to describe • sociodemographic characteristics and dietary and lifestyle behaviours in Italian and immigrant pregnant women who underwent a GDM screening; • any differences in these aspects among GDM Italian and immigrant women; • any differences in terms of primary maternal-neonatal outcomes among GDM and normal glucose tolerance (NGT) cohorts.
survey.
this survey was conducted in three hospitals located in Tuscany Region (Central Italy). According to a convenience sampling, an ad hoc questionnaire was administered both to Italian and immigrant women who underwent an oral glucose tolerance test.
information about nutrition and lifestyle, medical and obstetric history, clinical and therapy data, maternal and neonatal primary outcomes was analysed. Eating habits have been investigated referring to thent diet at the time of GDM screening. An ethnic and tailored meal plan is needed to overcome cultural barriers in dietary recommendations during pregnancy in immigrant women.
to evaluate immunogenicity and effectiveness of BNT162b2 COVID-19 vaccine in a cohort of healthcare workers (HCWs).
cohort study.
in a hospital in Milan (Lombardy Region, Northern Italy) HCWs without ("negative cohort") and with ("positive cohort") history of SARS-CoV-2 infection or elevated serum antibody before the vaccination campaign (27.12.2020) were included. Data collection and follow-up covered the period 27.12.2020-13.05.2022.
1. serum anti-spike-1 (anti-S1) antibody levels after vaccination; 2. vaccine effectiveness (VE) against SARS-CoV-2 infections (either symptomatic or not) in the negative cohort. Data on infections were extracted from multiple sources (laboratory, accident reports, questionnaires). Vaccination was treated as a time-dependent variable. Using unvaccinated person-time as reference, hazard ratios (HR) of infections and 95% confidence intervals (95%CI) were calculated with a Cox regression model adjusted for gender, age, and occupation. VE was calculated as (1 - HR)×100.
5,596 HCWs were included, 4,771 in the negative and 825 in the positive cohort. In both cohorts, serum anti-S1 antibodies were high one months after the second dose, halved after six months, and returned to high levels after the third dose. In the negative cohort, 1,401 SARS-CoV-2 infections were identified. VE was 70% (95%CI 54-80; 46 infected) in the first four months after the second dose and later declined to 16% (95%CI 0-43; 97 infected). After the third dose, VE increased to 57% (95%CI 35-71; 61 infected) in the first month but rapidly declined over time, particularly after three months (24% in the fourth month and 1% afterwards). The number of infections avoided by vaccination was estimated to be 643 (95%CI 236-1,237).
in spite of rapidly declining effectiveness, vaccination helped to avoid several hundred infections in the considered hospital.
in spite of rapidly declining effectiveness, vaccination helped to avoid several hundred infections in the considered hospital.
Although cardiac myxoma (CM) are rare and benign, they can cause life-threatening complications, such as hemodynamic disturbances or embolization. Surgical excision of the tumour is the treatment of choice. The aim of the study was to evaluate the epidemiological characteristics, clinical presentation, imaging findings, and outcomes of surgical treatment of patients with CM treated in the largest tertiary care centre in Slovenia.
We retrospectively analysed the medical records of all patients referred to our institution between January 2005 and December 2020 and identified 39 consecutive adult patients with pathologically confirmed CM.
The average annual incidence of CM in the study was 3 per 2 million population per year. Patients were more often female (n = 25, 64%). The mean age at diagnosis was 63.1 ± 13.6 years. Dyspnoea was the most common presenting symptom (31%). CM was an incidental finding in 11 patients (28%). Seven patients presented with thromboembolic event (18%). Transthoracic echocardiography (TTE) was performed in all patients, however additional imaging was required in 22 patients (56%). Baricitinib All patients in our series were successfully treated surgically without in-hospital mortality. During the follow-up period (6 months to 16 years) three patients (8%) died, and all deaths were unrelated to CM. There was no recurrence of CM during the follow-up.
Our single-centre study confirms that CM is rare cardiac tumour with diverse clinical presentation. Our data shows data that CM might be more prevalent than considered before. Surgical resection of the tumour is safe with excellent short- and long-term outcomes.
Our single-centre study confirms that CM is rare cardiac tumour with diverse clinical presentation. Our data shows data that CM might be more prevalent than considered before. Surgical resection of the tumour is safe with excellent short- and long-term outcomes.In this paper, the wing body fusion method is used to complete the design of underwater glider. On this basis, the traditional optimization algorithm of underwater gliding wing shape is improved. Based on the improved Hicks Henne algorithm and genetic algorithm, the shape optimization of underwater glider is completed. Through the further optimization of the overall performance, the overall shape of the glider is improved and the maximum lift drag ratio is increased. Finally, the physical experiment of the optimized shape is carried out according to the experimental water area of the circulating water tank. Through the comparative analysis of the data, the accuracy of the numerical calculation is verified.
To evaluate the safety and efficacy of stenting for symptomatic intracranial atherosclerotic severe stenosis or occlusion with Enterprise stents.
Fifty-three consecutive patients with symptomatic intracranial atherosclerotic severe (70%-99%) stenosis or occlusion who underwent endovascular treatment with Enterprise stents between September 2019 and March 2022 were retrospectively analyzed. Primary outcomes included technical stenting success rates, the incidence of complications within 30 days of the procedure, and the in-stent restenosis rates during the follow-up period. These outcomes were further categorized based on lesion location and operation time.
Fifty-seven lesions in 53 patients aged 61.0 ± 10.0 years were treated with Enterprise stents with a technical success rate of 100%. Seven patients (12.3%) had severe complications within 30 days of the procedure five had a symptomatic ischemic stroke, one had a symptomatic intracerebral hemorrhage, and one had a subarachnoid hemorrhage related to theindicates that stenting during the early nonacute stage after stroke may not increase the incidence of perioperative complications for symptomatic intracranial atherosclerotic stenosis when following strict inclusion criteria.
Head and neck cancer services have had to adapt to reduce the risk of exposure to patients and staff during the pandemic. Telephone consultations as a first point contact have been adopted in some centres. It is important that this does not lead to delays in diagnosis. Our hospital adopted a telephone triage service and we aim to describe the implications of this structure.
Data were collected from all new patients referred to the head and neck 2-week-wait (2ww) pathway from June to September of 2019 and 2020. Days between first clinic appointment and cancer or noncancer diagnosis were calculated. Statistical tests were performed between years.
A total of 215 patients in 2019, and 165 in 2020 were included; 23 (6.8%) cancer diagnoses were identified across 2019 and 2020 groups. The cancer group had a mean time from first consultation to date of diagnosis of 16.33 days in 2019 and 12.81 days in 2020. There was no significant difference in days until diagnosis between 2019 and 2020 (
=0.05). In the noncancer group there was no significant difference in days until noncancer diagnosis (
=0.05). In 2020 26.1% (
=43) patients did not need to be seen face-to-face (f2f) under the 2ww pathway after telephone triage.
No difference in diagnosis timing was observed between cancer and noncancer patents in 2019 and 2020. Telephone clinics reduce the total number of f2f appointments required. Reduction in the number of f2f appointments may have other benefits in saving time and environmental costs.
No difference in diagnosis timing was observed between cancer and noncancer patents in 2019 and 2020. Telephone clinics reduce the total number of f2f appointments required. Reduction in the number of f2f appointments may have other benefits in saving time and environmental costs.