Intravascular Ultrasound in the Detection of Bridging Stent Graft Instability During Fenestrated and Branched Endovascular Aneurysm Repair Procedures: A Multicentre Study on 274 Target Vessels

Objective: The use of intravascular ultrasound (IVUS) reduces contrast medium use and radiation exposure during conventional endovascular aneurysm repair (EVAR). The aim of this study was to evaluate the safety and efficacy of IVUS in detecting bridging stent graft (bSG) instability during fenestrated and branched EVAR (F/B-EVAR). Methods: This was a prospective observational multicentre study. The following outcomes were evaluated: (1) technical success of the IVUS in each bSG, (2) IVUS findings compared with intra-operative angiography, (3) incidence of post-operative computed tomography angiography (CTA) findings not detected with IVUS, and (4) absence of IVUS related adverse events. Target visceral vessel (TVV) instability was defined as any branch or fenestration issues requiring an additional manoeuvre or re-intervention. Any IVUS assessment that detected stenosis, kinking, or any geometric TVV issue was considered to be branch instability. All procedures were performed in ad hoc hybrid rooms. Results: Eighty patients (69% males; median age 72 years; interquartile range 59, 77 years) from four aortic centres treated with F/B-EVAR between January 2019 and September 2021 were included: 70 BEVAR (21 off the shelf; 49 custom made), eight FEVAR (custom made), and two F/B-EVAR (custom made), for a total of 300 potential TVVs. Two TVVs (0.7%) were left unstented and excluded from the analysis. The TVVs could not be accessed with the IVUS catheter in seven cases (2.3%). Furthermore, 17 (5.7%) TVVs could not be examined due to a malfunction of the IVUS catheter. The technical success of the IVUS assessment was 91.9% (274/298), with no IVUS related adverse events. Seven TVVs (2.5%) showed signs of bSG instability by means of IVUS, leading to immediate revisions. The first post-operative CTA at least 30 days after the index procedure was available in 268 of the 274 TVVs originally assessed by IVUS. In seven of the 268 TVVs (2.6%) a re-intervention became necessary due to bSG instability. Conclusion: This study suggests that IVUS is a safe and potentially valuable adjunctive imaging technology for intra-operative detection of TVV instability. Further long term investigations on larger cohorts are required to validate these promising results and to compare IVUS with alternative technologies in terms of efficiency, radiation exposure, procedure time, and costs

Biospas proyecto 2 : micorrizas, patógenos, meso-macro-fauna y biocontrol (Pae- pid-2007-0054)

El actual sistema agrícola de Argentina basa la mayor parte de su producción en la siembra directa y una limitada rotación de cultivos. En base a el paradigma de la sustentabilidad se pueden evaluar cambios en la asociación de Hongos Micorrícicos (HM) con raíces de diversos cultivos y las poblaciones presentes en el suelo; la incidencia de enfermedades en el cultivo y los niveles de inóculo presentes en los rastrojos y asimismo la supresividad de los suelos y por consiguiente la presencia de enfermedad de los cultivos y el efecto de control que pudieran proveer las Micorrizas Arbusculares (MA). El planteo de SD versus LT también plantea modificaciones tanto de la estructura del suelo como en el sistema y las comunidades de Meso y Macrofauna (MMF) que en él habitan. La hipótesis de trabajo plantea que la incidencia y severidad de las fitoenfermedades puede disminuirse por la rotación de cultivos y que las poblaciones de hongos micorrícicos se modifican según la secuencia de rotación. Esto a su vez implica que, incidencia y/o severidad de una enfermedad pueden ser modificadas por HM presentes en el suelo. Por otro lado, abundancia y atributos estructurales de la comunidad de MMF del suelo son afectados por los sistemas de manejo. En este proyecto se determinaran morfológica y molecularmente las especies integrantes de las poblaciones de HM en diferentes secuencias de cultivo. Se compararán las poblaciones de HM presentes en el suelo y las poblaciones en simbiosis activa con raíces de los diferentes cultivos. Se caracterizará y comparará cultivo, suelo y rastrojo desde el punto de vista fitopatológico en diferentes esquemas de rotación. Como resultado de esto se determinará la existencia de interacciones entre la incidencia de enfermedades y la presencia de determinadas micorrizas y evaluar el efecto de cada sistema de manejo sobre la abundancia y los atributos estructurales de la comunidad de MMF del suelo.Fil: Ducasse, Daniel Adrián. Universidad Católica de Córdoba. Facultad de Ciencias Agropecuarias; ArgentinaFil: Plazas, María Cristina. Universidad Católica de Córdoba. Facultad de Ciencias Agropecuarias; ArgentinaFil: De Rossi, Roberto Luis. Universidad Católica de Córdoba. Facultad de Ciencias Agropecuarias; ArgentinaFil: Guerra, Gustavo Darío. Universidad Católica de Córdoba. Facultad de Ciencias Agropecuarias; Argentin

Biospas Proyecto 2 : Micorrizas, Patógenos, Meso-Macro-Fauna y Biocontrol (PAE- PID-2007-0054)

El actual sistema agrícola de Argentina basa la mayor parte de su producción en la siembra directa y una limitada rotación de cultivos. En base a el paradigma de la sustentabilidad se pueden evaluar cambios en la asociación de Hongos Micorrícicos (HM) con raíces de diversos cultivos y las poblaciones presentes en el suelo; la incidencia de enfermedades en el cultivo y los niveles de inóculo presentes en los rastrojos y asimismo la supresividad de los suelos y por consiguiente la presencia de enfermedad de los cultivos y el efecto de control que pudieran proveer las Micorrizas Arbusculares (MA). El planteo de SD versus LT también plantea modificaciones tanto de la estructura del suelo como en el sistema y las comunidades de Meso y Macrofauna (MMF) que en él habitan. La hipótesis de trabajo plantea que la incidencia y severidad de las fitoenfermedades puede disminuirse por la rotación de cultivos y que las poblaciones de hongos micorrícicos se modifican según la secuencia de rotación. Esto a su vez implica que, incidencia y/o severidad de una enfermedad pueden ser modificadas por HM presentes en el suelo. Por otro lado, abundancia y atributos estructurales de la comunidad de MMF del suelo son afectados por los sistemas de manejo. En este proyecto se determinaran morfológica y molecularmente las especies integrantes de las poblaciones de HM en diferentes secuencias de cultivo. Se compararán las poblaciones de HM presentes en el suelo y las poblaciones en simbiosis activa con raíces de los diferentes cultivos. Se caracterizará y comparará cultivo, suelo y rastrojo desde el punto de vista fitopatológico en diferentes esquemas de rotación. Como resultado de esto se determinará la existencia de interacciones entre la incidencia de enfermedades y la presencia de determinadas micorrizas y evaluar el efecto de cada sistema de manejo sobre la abundancia y los atributos estructurales de la comunidad de MMF del suelo.Fil: Ducasse, Daniel Adrián. Universidad Católica de Córdoba. Facultad de Ciencias Agropecuarias; ArgentinaFil: Plazas, María Cristina. Universidad Católica de Córdoba. Facultad de Ciencias Agropecuarias; Argentin

Documenting the Recovery of Vascular Services in European Centres Following the Initial COVID-19 Pandemic Peak: Results from a Multicentre Collaborative Study

Objective: To document the recovery of vascular services in Europe following the first COVID-19 pandemic peak. Methods: An online structured vascular service survey with repeated data entry between 23 March and 9 August 2020 was carried out. Unit level data were collected using repeated questionnaires addressing modifications to vascular services during the first peak (March – May 2020, “period 1”), and then again between May and June (“period 2”) and June and July 2020 (“period 3”). The duration of each period was similar. From 2 June, as reductions in cases began to be reported, centres were first asked if they were in a region still affected by rising cases, or if they had passed the peak of the first wave. These centres were asked additional questions about adaptations made to their standard pathways to permit elective surgery to resume. Results: The impact of the pandemic continued to be felt well after countries’ first peak was thought to have passed in 2020. Aneurysm screening had not returned to normal in 21.7% of centres. Carotid surgery was still offered on a case by case basis in 33.8% of centres, and only 52.9% of centres had returned to their normal aneurysm threshold for surgery. Half of centres (49.4%) believed their management of lower limb ischaemia continued to be negatively affected by the pandemic. Reduced operating theatre capacity continued in 45.5% of centres. Twenty per cent of responding centres documented a backlog of at least 20 aortic repairs. At least one negative swab and 14 days of isolation were the most common strategies used for permitting safe elective surgery to recommence. Conclusion: Centres reported a broad return of services approaching pre-pandemic “normal” by July 2020. Many introduced protocols to manage peri-operative COVID-19 risk. Backlogs in cases were reported for all major vascular surgeries

Meta-analysis of negative pressure wound therapy of closed groin incisions in arterial surgery

Background: Surgical-site infection (SSI) after groin incisions for arterial surgery is common and may lead to amputation or death. Incisional negative pressure wound therapy (NPWT) dressings have been suggested to reduce SSIs. The aim of this systematic review with meta-analysis was to assess the effects of incisional NPWT on the incidence of SSI in closed groin incisions after arterial surgery. Methods: A study protocol for this systematic review of RCTs was published in Prospero (CRD42018090298) a priori, with predefined search, inclusion and exclusion criteria. The records generated by the systematic research were screened for relevance by title and abstract and in full text by two of the authors independently. The selected articles were rated for bias according to the Cochrane risk-of-bias tool. Results: Among 1567 records generated by the search, seven RCTs were identified, including 1049 incisions. Meta-analysis showed a reduction in SSI with incisional NPWT (odds ratio (OR) 0·35, 95 per cent c.i. 0·24 to 0·50; P < 0·001). The heterogeneity between the included studies was low (I 2 = 0 per cent). The quality of evidence was graded as moderate. Two studies had multiple domains in the Cochrane risk-of-bias tool rated as high risk of bias. A subgroup meta-analysis of three studies of lower limb revascularization procedures only (363 incisions) demonstrated a similar reduction in SSI (OR 0·37, 0·22 to 0·63; P < 0·001; I 2 = 0 per cent). Conclusion: Incisional NPWT after groin incisions for arterial surgery reduced the incidence of SSI compared with standard wound dressings. The risk of bias highlighted the need for a high-quality RCT with cost-effectiveness analysis

Smoking in Italy 2013-2014, with a focus on the young

AIMS: To update smoking prevalence trends in Italy among adult and young populations; to determine the recent spread, particularly among young smokers, of roll-your-own (RYO) cigarettes (which cost approximately half the price of manufactured cigarettes); and to evaluate the effects of 2013 legislation increasing the minimum tobacco purchasing age from 16 to 18 years in Italy.METHODS: Two surveys on smoking were conducted in 2013 and 2014 in Italy, on a total sample of 6052 individuals, representative each year of the national population aged 6515 years, where we collected data on type of tobacco most frequently smoked and on the perception of the enforcement of the tobacco sales-to-minors legislation.RESULTS: A total of 21.1% of the population surveyed were smokers (25.5% of men and 17.0% of women). Prevalence of current smoking among young participants (15-24 years) was 19.9% (21.7% of male participants and 18.0% of female participants). Overall, 6.9% of smokers, and 13.3% of young smokers, reported RYO cigarettes as the most frequently smoked tobacco product. More than 80% of Italian adults had never seen a tobacco retailer refuse to sell cigarettes to minors (i.e., aged <18 years) or request their identification or age.CONCLUSIONS: Although adult and young smoking prevalence rates substantially decreased over the last few decades, neither of them have significantly changed since 2007. Use of RYO cigarettes is increasing, particularly among the young. Our study highlights the need to equalize the costs of different types of tobacco products and to improve the enforcement of the current tobacco sales-to-minors legislation

Regular use of aspirin for cardiovascular disease prevention in Italy

Objective: Only a few European studies focused on aspirin use in the general population. We provide updated information on the prevalence and determinants of regular aspirin use for the prevention of cardiovascular disease (CVD) in the Italian adult population. Method: We used data from a survey conducted in Italy in 2013, on a sample of 3000 individuals, representative of the general Italian population aged 65. 15. years. Results: Overall, 10.9% of Italians reported a regular use of aspirin, 11.2% of men and 10.5% of women. Aspirin use significantly increased with age. The highest prevalence of aspirin use was observed among the elderly (30.3%), ex-smokers (22.6%), and in individuals with a diagnosis of diabetes (52.0%), hypertension (42.6%) or hypercholesterolemia (38.6%). After adjustment for several covariates, no significant heterogeneity in aspirin use was observed according to education, body mass index, and physical activity. Only 1.2% of low CVD risk individuals regularly used aspirin versus 48.3% of individuals with high CVD risk. Conclusion: About 3.4. million high CVD risk Italians do not regularly use aspirin for primary or secondary prevention. Thus, more widespread preventive strategy is recommended for this population, once individual benefits of regular aspirin use exceed harms. \ua9 2014 Elsevier Inc

Which group of smokers is more vulnerable to the economic crisis?

Objectives: Studies investigating whether smoking increases or decreases during economic downturn provided contrasting results. For the first time, we used direct questions to analyse changes in smoking behaviour due to the 2008 financial crisis, comparing socio-economic characteristics of smokers who changed with those who kept their smoking intensity. Study design: Cross-sectional survey. Methods: We used data from three annual surveys conducted in Italy in 2012-2014 on representative samples of the Italian general population aged ≥15 years. Results: A total of 1919 current smokers were asked specific questions on the influence of the economic crisis that started in 2008 on their smoking behaviour. Overall, 77.4% of 1919 current smokers reported not to have changed their smoking behaviour, 19.1% to have reduced, and 3.5% to have increased their smoking intensity as a consequence of the economic crisis. The reduction in cigarette smoking increased with age: compared to the respondents aged <25 years, the multivariate odds ratio (OR) for those aged 25-44, 45-64 and ≥65 years were 0.65, 0.46 and 0.33, respectively (P for trend<0.001). Reduction was significantly lower among intermediate (OR = 0.68 compared to low) and high education levels (OR = 0.28; P for trend<0.001). A significant inverse trend for increasing consumption was observed with age (P = 0.022), education (P = 0.003) and family income (P < 0.001). Conclusions: The large majority of current smokers did not change their smoking habit following the economic crisis. However, there are specific vulnerable subgroups of smokers, constituted by the young and subjects with low socio-economic status, that were reactive to the global economic crisis. These groups are more prone to change their smoking behaviours, either for better or -, in a smaller proportion -, for worse