Outpatient healthcare costs associated with overweight and obesity in Italy

To evaluate outpatient healthcare expenditure associated with different levels of BMI and glucose metabolism alterations

Tumor Infiltrating Neutrophils Are Enriched in Basal-Type Urothelial Bladder Cancer

15noBackground: Urothelial bladder cancers (UBCs) are distinct in two main molecular subtypes, namely basal and luminal type. Subtypes are also diverse in term of immune contexture, providing a rationale for patient selection to immunotherapy. Methods: By digital microscopy analysis of a muscle-invasive BC (MIBC) cohort, we explored the density and clinical significance of CD66b(+) tumor-associated-neutrophils (TAN) and CD3(+) T cells. Bioinformatics analysis of UBC datasets and gene expression analysis of UBC cell lines were additionally performed. Results: Basal type BC contained a significantly higher density of CD66b(+) TAN compared to the luminal type. This finding was validated on TCGA, GSE32894 and GSE124305 datasets by computing a neutrophil signature. Of note, basal-type MIBC display a significantly higher level of chemokines (CKs) attracting neutrophils. Moreover, pro-inflammatory stimuli significantly up-regulate CXCL1, CXCL2 and CXCL8 in 5637 and RT4 UBC cell lines and induce neutrophil chemotaxis. In term of survival, a high density of T cells and TAN was significantly associated to a better outcome, with TAN density showing a more limited statistical power and following a non-linear predicting model. Conclusions: TAN are recruited in basal type MIBC by pro-inflammatory CKs. This finding establishes a groundwork for a better understanding of the UBC immunity and its relevance.openopenMandelli, Giulio Eugenio; Missale, Francesco; Bresciani, Debora; Gatta, Luisa Benerini; Scapini, Patrizia; Caveggion, Elena; Roca, Elisa; Bugatti, Mattia; Monti, Matilde; Cristinelli, Luca; Belotti, Sandra; Simeone, Claudio; Calza, Stefano; Melocchi, Laura; Vermi, WilliamMandelli, Giulio Eugenio; Missale, Francesco; Bresciani, Debora; Gatta, Luisa Benerini; Scapini, Patrizia; Caveggion, Elena; Roca, Elisa; Bugatti, Mattia; Monti, Matilde; Cristinelli, Luca; Belotti, Sandra; Simeone, Claudio; Calza, Stefano; Melocchi, Laura; Vermi, Willia

Hybrid Approach to Atrial Fibrillation Ablation

Sequential surgical thoracoscopic and electrophysiological (EP) ablation is gaining popularity as a novel approach for the treatment of patients with stand-alone, persistent and long standing persistent atrial fibrillation (AF)

The Far-Infrared Radiation Mobile Observation System (FIRMOS) for spectral characterization of the atmospheric emission

The Far-Infrared Radiation Mobile Observation System (FIRMOS) is a Fourier transform spectroradiometer developed to support the Far-infrared Outgoing Radiation Understanding and Monitoring (FORUM) satellite mission by validating measurement methods and instrument design concepts, both in the laboratory and in field campaigns. FIRMOS is capable of measuring the downwelling spectral radiance emitted by the atmosphere in the spectral band from 100 to 1000 cm$^{−1}$ (10–100 µm in wavelength), with a maximum spectral resolution of 0.25 cm$^{−1}$. We describe the instrument design and its characterization and discuss the geophysical products obtained by inverting the atmospheric spectral radiance measured during a campaign from the high-altitude location of Mount Zugspitze in Germany, beside the Extended-range Atmospheric Emitted Radiance Interferometer (E-AERI), which is permanently installed at the site. Following the selection of clear-sky scenes, using a specific algorithm, the water vapour and temperature profiles were retrieved from the FIRMOS spectra by applying the Kyoto protocol and Informed Management of the Adaptation (KLIMA) code. The profiles were found in very good agreement with those provided by radiosondes and by the Raman lidar operating from the Zugspitze Schneefernerhaus station. In addition, the retrieval products were validated by comparing the retrieved integrated water vapour values with those obtained from the E-AERI spectra

"Delirium Day": A nationwide point prevalence study of delirium in older hospitalized patients using an easy standardized diagnostic tool

Background: To date, delirium prevalence in adult acute hospital populations has been estimated generally from pooled findings of single-center studies and/or among specific patient populations. Furthermore, the number of participants in these studies has not exceeded a few hundred. To overcome these limitations, we have determined, in a multicenter study, the prevalence of delirium over a single day among a large population of patients admitted to acute and rehabilitation hospital wards in Italy. Methods: This is a point prevalence study (called "Delirium Day") including 1867 older patients (aged 65 years or more) across 108 acute and 12 rehabilitation wards in Italian hospitals. Delirium was assessed on the same day in all patients using the 4AT, a validated and briefly administered tool which does not require training. We also collected data regarding motoric subtypes of delirium, functional and nutritional status, dementia, comorbidity, medications, feeding tubes, peripheral venous and urinary catheters, and physical restraints. Results: The mean sample age was 82.0 \ub1 7.5 years (58 % female). Overall, 429 patients (22.9 %) had delirium. Hypoactive was the commonest subtype (132/344 patients, 38.5 %), followed by mixed, hyperactive, and nonmotoric delirium. The prevalence was highest in Neurology (28.5 %) and Geriatrics (24.7 %), lowest in Rehabilitation (14.0 %), and intermediate in Orthopedic (20.6 %) and Internal Medicine wards (21.4 %). In a multivariable logistic regression, age (odds ratio [OR] 1.03, 95 % confidence interval [CI] 1.01-1.05), Activities of Daily Living dependence (OR 1.19, 95 % CI 1.12-1.27), dementia (OR 3.25, 95 % CI 2.41-4.38), malnutrition (OR 2.01, 95 % CI 1.29-3.14), and use of antipsychotics (OR 2.03, 95 % CI 1.45-2.82), feeding tubes (OR 2.51, 95 % CI 1.11-5.66), peripheral venous catheters (OR 1.41, 95 % CI 1.06-1.87), urinary catheters (OR 1.73, 95 % CI 1.30-2.29), and physical restraints (OR 1.84, 95 % CI 1.40-2.40) were associated with delirium. Admission to Neurology wards was also associated with delirium (OR 2.00, 95 % CI 1.29-3.14), while admission to other settings was not. Conclusions: Delirium occurred in more than one out of five patients in acute and rehabilitation hospital wards. Prevalence was highest in Neurology and lowest in Rehabilitation divisions. The "Delirium Day" project might become a useful method to assess delirium across hospital settings and a benchmarking platform for future surveys

Comparison of Perioperative Morbidity of Radical Cystectomy with Neobladder Versus Ileal Conduit: A Matched Pair Analysis of 170 Patients

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