Dinosaur tracks in the Struganik quarry (Western Serbia)

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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

Antidiabetic Drug Prescription Pattern in Hospitalized Older Patients with Diabetes

Objective: To describe the prescription pattern of antidiabetic and cardiovascular drugs in a cohort of hospitalized older patients with diabetes. Methods: Patients with diabetes aged 65 years or older hospitalized in internal medicine and/or geriatric wards throughout Italy and enrolled in the REPOSI (REgistro POliterapuie SIMI—Società Italiana di Medicina Interna) registry from 2010 to 2019 and discharged alive were included. Results: Among 1703 patients with diabetes, 1433 (84.2%) were on treatment with at least one antidiabetic drug at hospital admission, mainly prescribed as monotherapy with insulin (28.3%) or metformin (19.2%). The proportion of treated patients decreased at discharge (N = 1309, 76.9%), with a significant reduction over time. Among those prescribed, the proportion of those with insulin alone increased over time (p = 0.0066), while the proportion of those prescribed sulfonylureas decreased (p < 0.0001). Among patients receiving antidiabetic therapy at discharge, 1063 (81.2%) were also prescribed cardiovascular drugs, mainly with an antihypertensive drug alone or in combination (N = 777, 73.1%). Conclusion: The management of older patients with diabetes in a hospital setting is often sub-optimal, as shown by the increasing trend in insulin at discharge, even if an overall improvement has been highlighted by the prevalent decrease in sulfonylureas prescription

The “Diabetes Comorbidome”: A Different Way for Health Professionals to Approach the Comorbidity Burden of Diabetes

(1) Background: The disease burden related to diabetes is increasing greatly, particularly in older subjects. A more comprehensive approach towards the assessment and management of diabetes’ comorbidities is necessary. The aim of this study was to implement our previous data identifying and representing the prevalence of the comorbidities, their association with mortality, and the strength of their relationship in hospitalized elderly patients with diabetes, developing, at the same time, a new graphic representation model of the comorbidome called “Diabetes Comorbidome”. (2) Methods: Data were collected from the RePoSi register. Comorbidities, socio-demographic data, severity and comorbidity indexes (Cumulative Illness rating Scale CIRS-SI and CIRS-CI), and functional status (Barthel Index), were recorded. Mortality rates were assessed in hospital and 3 and 12 months after discharge. (3) Results: Of the 4714 hospitalized elderly patients, 1378 had diabetes. The comorbidities distribution showed that arterial hypertension (57.1%), ischemic heart disease (31.4%), chronic renal failure (28.8%), atrial fibrillation (25.6%), and COPD (22.7%), were the more frequent in subjects with diabetes. The graphic comorbidome showed that the strongest predictors of death at in hospital and at the 3-month follow-up were dementia and cancer. At the 1-year follow-up, cancer was the first comorbidity independently associated with mortality. (4) Conclusions: The “Diabetes Comorbidome” represents the perfect instrument for determining the prevalence of comorbidities and the strength of their relationship with risk of death, as well as the need for an effective treatment for improving clinical outcomes

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

Indagine sulle prospettive evolutive dei settori produttivi e analisi dei fabbisogni di innovazione e formazione nel settore "economia del mare"

Il PoloFormare ha prodotto un Rapporto mirato ad approfondire la conoscenza del comparto "Economia del Mare" nella regione Campania al fine di analizzare i fabbisogni di innovazione e formazione dei relativi settori produttivi alla luce delle loro prevista evoluzione nonché delle relative prospettive occupazionali. Lo scopo è individuare i corsi IFTS più consoni alle esigenze delle aziende del comparto. L'analisi dei fabbisogni di innovazione e formazione è condotta secondo una metodologia definita Quality Function Deployment (QFD). Tale approccio consente di ricercare e focalizzare le informazioni necessarie a trasferire le aspettative del cliente finale in appropriati standard di prodotto, di processo e di controllo. Una caratteristica fondamentale di questa metodologia è che esso non può prescindere dal lavoro di gruppo. Ad ogni fase di transizione devono necessariamente partecipare il cliente, specificando i suoi requisiti, ed il fornitore, illustrando le sue proposte. In questo senso il QFD è un efficace strumento per il confronto, la contrattazione e la condivisione e, quindi, per il soddisfacimento delle esigenze del cliente. Nella nostra analisi il cliente è costituito dall’azienda operante nell’economia del mare che esprime determinati fabbisogni professionali e formativi

Reconstruction of a hidro-stratigrapic model based on geological stratigraphic model in the basement of the urban area of Bagnoli; validation on the basis of existing hydrogeological data.

Reconstruction of a Hydro-stratigraphic model based on hysdrostratigraphic sections generated on the basis of 3D geological model of depositional facies. This hydrostratigraphic model confirm the hydrogeological pattern established by Celico et alii. 2002 , water table levels and watersheds obtained from hydrogeological data

Terraced Landforms Onshore and Offshore the Cilento Promontory (South-Eastern Tyrrhenian Margin) and Their Significance as Quaternary Records of Sea Level Changes

Climate change and tectonic uplift are the dominant forcing mechanisms responsible for the formation of long and narrow terraced landforms in a variety of geomorphic settings; and marine terraces are largely used to reconstruct the Quaternary glacial and interglacial climates. Along the Mediterranean coast, a considerable number of popular scientific articles have acknowledged a range of marine terraces in the form of low-relief surfaces resulting from the combined effects of tectonic uplift and eustatic sea-level fluctuations, as relevant geomorphological indicators of past sea-level high-stands. With the exception of a few recent studies on the significance of submarine depositional terraces (SDT), submerged terraced landforms have been less investigated. By integrating different marine and terrestrial datasets, our work brings together and re-examines numerous terraced landforms that typify the Cilento Promontory and its offshore region. In this area, studies since the 1960s have allowed the recognition of well-defined Middle to Upper Pleistocene marine terraces on land, while only a few studies have investigated the occurrences of late Pleistocene SDT. Furthermore, to date, no studies have consistently integrated findings. For our work, we correlated major evidence of emerged and submarine terraced landforms in order to support an improved understanding of the tectono-geomorphological evolution of the Cilento Promontory and to further clarify the geomorphological significance of submerged terraces