Clinical features and outcomes of elderly hospitalised patients with chronic obstructive pulmonary disease, heart failure or both

Background and objective: Chronic obstructive pulmonary disease (COPD) and heart failure (HF) mutually increase the risk of being present in the same patient, especially if older. Whether or not this coexistence may be associated with a worse prognosis is debated. Therefore, employing data derived from the REPOSI register, we evaluated the clinical features and outcomes in a population of elderly patients admitted to internal medicine wards and having COPD, HF or COPD + HF. Methods: We measured socio-demographic and anthropometric characteristics, severity and prevalence of comorbidities, clinical and laboratory features during hospitalization, mood disorders, functional independence, drug prescriptions and discharge destination. The primary study outcome was the risk of death. Results: We considered 2,343 elderly hospitalized patients (median age 81 years), of whom 1,154 (49%) had COPD, 813 (35%) HF, and 376 (16%) COPD + HF. Patients with COPD + HF had different characteristics than those with COPD or HF, such as a higher prevalence of previous hospitalizations, comorbidities (especially chronic kidney disease), higher respiratory rate at admission and number of prescribed drugs. Patients with COPD + HF (hazard ratio HR 1.74, 95% confidence intervals CI 1.16-2.61) and patients with dementia (HR 1.75, 95% CI 1.06-2.90) had a higher risk of death at one year. The Kaplan-Meier curves showed a higher mortality risk in the group of patients with COPD + HF for all causes (p = 0.010), respiratory causes (p = 0.006), cardiovascular causes (p = 0.046) and respiratory plus cardiovascular causes (p = 0.009). Conclusion: In this real-life cohort of hospitalized elderly patients, the coexistence of COPD and HF significantly worsened prognosis at one year. This finding may help to better define the care needs of this population

Gamma-ray astronomy with ARGO-YBJ

ARGO-YBJ is a full coverage air shower array located at the YangBaJing Cosmic Ray Laboratory (Tibet, P.R. China, 4300 m a.s.l., 606 g/cm2) recording data with a duty cycle ≥85% and an energy threshold of a few hundred GeV. In this paper the latest results in Gamma-Ray Astronomy are summarized

Gamma-ray astronomy and cosmic-ray physics with ARGO-YBJ

The ARGO-YBJ detector, located 4300 m a.s.l. on the Tibet plateau, is a ground-based, full- coverage array of Resistive Plate Chambers (RPCs) covering a surface of 78×74 m2, surrounded by a guard ring of RPCs enclosing a total surface of about 11000 m2. ARGO-YBJ was designed to detect extensive air showers generated by cosmic rays and gamma rays with primary energy greater than few hundred GeV, in order to study the region of the cosmic-ray spectrum out of the reach of both satellite-based experiments and traditional ground-based arrays. The experiment has been running with its complete layout since November 2007, collecting over 2:5×1011 events. The main results obtained by ARGO-YBJ will be presented here, and specifically: the monitoring of astronomical gamma-ray sources, such as the Crab nebula and the MRK 421 AGN, the moon shadow, the medium-scale anisotropy map, the proton-proton inelastic cross section at center-of- mass energy between 70 and 500 GeV where no accelerator data are available