SARS-CoV-2 infection predicts larger infarct volume in patients with acute ischemic stroke

Background and purpose: Acute ischemic stroke (AIS) is a fearful complication of Coronavirus Disease-2019 (COVID-19). Aims of this study were to compare clinical/radiological characteristics, endothelial and coagulation dysfunction between acute ischemic stroke (AIS) patients with and without COVID-19 and to investigate if and how the SARS-CoV-2 spike protein (SP) was implicated in triggering platelet activation. Methods: We enrolled AIS patients with COVID-19 within 12 h from onset and compared them with an age- and sex-matched cohort of AIS controls without COVID-19. Neuroimaging studies were performed within 24 h. Blood samples were collected in a subset of 10 patients. Results: Of 39 AIS patients, 22 had COVID-19 and 17 did not. Admission levels of Factor VIII and von Willebrand factor antigen were significantly higher in COVID-19 patients and positively correlated with the infarct volume. In multivariate linear regression analyses, COVID-19 was an independent predictor of infarct volume (B 20.318, Beta 0.576, 95%CI 6.077-34.559; p = 0.011). SP was found in serum of 2 of the 10 examined COVID-19 patients. Platelets from healthy donors showed a similar degree of procoagulant activation induced by COVID-19 and non-COVID-19 patients' sera. The anti-SP and anti-FcγRIIA blocking antibodies had no effect in modulating platelet activity in both groups. Conclusions: SARS-CoV-2 infection seems to play a major role in endothelium activation and infarct volume extension during AIS

VERT-X: VERTical X-ray raster-scan facility for ATHENA calibration. The concept design

Calibration of the ATHENA telescope is a critical aspect of the project and raises significant difficulties due to the unprecedented size, mass and focal length of the mirror assembly. The VERT-X project, financed by ESA and started in January 2019 by a Consortium led by INAF and which includes EIE, Media Lario Technologies, GPAP, and BCV Progetti, aims to design an innovative calibration facility. In the VERT-X design the parallel beam, needed for calibration, is produced placing a source in the focus of an X-ray collimator. This system is mounted on a raster-scan mechanism which covers the entire ATHENA optics. The compactness of the VERT-X design allows a vertical geometry for the ATHENA calibration facility, with several potential benefits with respect to the long horizontal tube calibration facilities

SOVRAINDEBITAMENTO LA NUOVA PROCEDURA DI COMPOSIZIONE DELLA CRISI DA SOVRAINDEBITAMENTO LEGGE 27 GENNAIO 2012 - N. 3

La legge 27 gennaio 2012 n. 3 pubblicata sulla Gazzetta Ufficiale del 30.01.2012 n. 24 entrta in vigore in data 29.02.2012 introduce, per prima volta, nel nostro ordinamento giuridico, una disciplina finalizzata alla composizione della crisi da sovraindebitamento che ha come destinatari tutti quei soggetti, siano essi persone fisiche o giuridiche che non potendo essere dichiarati falliti non possono beneficiare delle procedure di definizione della crisi previste dalla legge fallimentare, quali il concordato preventivo e gli accordi di ristrutturazione di cui all'art. 182 bis L.F. L'opera si propone come una prima riflessione sulla architettura giuridico-funzionale della procedura nell'immediatezza della sua entrata in vigore analizzandone in modo critico gli aspetti più problematici nel tentaivo di fornire prime soluzioni. La materia è in evoluzione tanto che, a poche settimane dalla sua entrata in vigore, il Consiglio dei Ministri ha approvato disegno di legge finalizzato a modificare in modo radicale l'impianto normativo della neo-introdotta procedura

Risk factors for anastomotic leakage after anterior resection for rectal cancer (RALAR study): A nationwide retrospective study of the Italian Society of Surgical Oncology Colorectal Cancer Network Collaborative Group

Aim: Anastomotic leakage after restorative surgery for rectal cancer shows high morbidity and related mortality. Identification of risk factors could change operative planning, with indications for stoma construction. This retrospective multicentre study aims to assess the anastomotic leak rate, identify the independent risk factors and develop a clinical prediction model to calculate the probability of leakage. Methods: The study used data from 24 Italian referral centres of the Colorectal Cancer Network of the Italian Society of Surgical Oncology. Patients were classified into two groups, AL (anastomotic leak) or NoAL (no anastomotic leak). The effect of patient-, disease-, treatment- and postoperative outcome-related factors on anastomotic leak after univariable and multivariable analysis was measured. Results: A total of 5398 patients were included, 552 in group AL and 4846 in group NoAL. The overall incidence of leaks was 10.2%, with a mean time interval of 6.8 days. The 30-day leak-related mortality was 2.6%. Sex, body mass index, tumour location, type of approach, number of cartridges employed, weight loss, clinical T stage and combined multiorgan resection were identified as independent risk factors. The stoma did not reduce the leak rate but significantly decreased leak severity and reoperation rate. A nomogram with a risk score (RALAR score) was developed to predict anastomotic leak risk at the end of resection. Conclusions: While a defunctioning stoma did not affect the leak risk, it significantly reduced its severity. Surgeons should recognize independent risk factors for leaks at the end of rectal resection and could calculate a risk score to select high-risk patients eligible for protective stoma construction