66 research outputs found

    Self-organization in Rome: a map

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    Durante gli ultimi anni, diverse ricerche sono state realizzate a Roma sul tema dello spazio e dell’autorganizzazione e molte di queste contengono importanti mappature. Tuttavia, questi processi sono molto dinamici e la situazione a Roma cambia ogni anno. Per questa ragione a novembre 2017 abbiamo deciso di realizzare, per della conferenza “City and Self-organization”, tenutasi a Roma a dicembre 2017, un aggiornamento della situazione dell’autorganizzazione romana, legata all’utilizzo dello spazio, attraverso una mappa, al fine di comprendere meglio la portata e i significati del fenomeno. Le principali domande alla base del contributo sono: perchĂ©, anche se questi spazi sono cosĂŹ numerosi, non riescono ad influenzare le politiche urbane? PerchĂ© sono concentrate prevalentemente in alcuni quartieri della cittĂ  e cosa rappresenta questa concentrazione? Quali sono le loro caratteristiche rispetto ad altri contesi europei? In che misura riescono a cambiare le istituzioni pubbliche?During the last years many different researches regarding social spaces have been realized in Rome, sometimes containing different maps representing these experiences. Nevertheless, these processes are very dynamic and the situation of Rome changes every year. For this reason in November, 2017 we decided to realize, during the International Conference “Cities and Selforganization” held in Rome on December 2017, an updated map of all the selforganization experiences within the city of Rome in order to better understand the reach and the meanings of this phenomenon. The main questions at the base of the present research are: why, even though these spaces are so copious, are not they able in influencing urban policies? Why are they concentrated mainly in some specific quarters of the city? What are their features compared to others European cities? To what extent are they able to change the public institutions

    The Swiss cheese model in takotsubo syndrome

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    Characterization of COVID-19-related lung involvement in patients undergoing magnetic resonance T1 and T2 mapping imaging: a pilot study

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    Tissue characterization by mapping techniques is a recent magnetic resonance imaging (MRI) tool that could aid the tissue characterization of lung parenchyma in coronavirus disease-2019 (COVID-19). The aim of the present study was to compare lung MRI findings, including T1 and T2 mapping, in a group of n = 11 patients with COVID-19 pneumonia who underwent a scheduled cardiac MRI, and a cohort of healthy controls. MRI scout images were used to identify affected and remote lung regions within the patients’ cohort and appropriate regions of interest (ROIs) were drawn accordingly. Both lung native T1 and T2 values were significantly higher in the affected areas of patients with COVID-19 as compared to the controls (1375 ms vs. 1201 ms, p = 0.016 and 70 ms vs. 30 ms, p < 0.001, respectively), whereas no significant differences were detected between the remote lung parenchyma of the COVID-19 patients and the controls (both p > 0.05). When a larger ROI was identified, comprising the whole lung parenchyma within the image irrespective of the affected and remote areas, the COVID-19 patients still retained higher native T1 (1278 ms vs. 1149 ms, p = 0.003) and T2 values (38 ms vs. 34 ms, p = 0.04). According to the receiver operator characteristics curves, the T2 value of the affected region retained the higher accuracy for the differentiation of the COVID-19 patients against the controls (area under the curve 0.934, 95% confidence interval 0.826–0.999). These findings, possibly driven by the ability of MRI tissue mapping to detect ongoing inflammation in the lungs of patients with COVID-19, suggest that T1 and T2 mapping of the lung is a feasible approach in this clinical scenario

    T1 and T2 Mapping in Uremic Cardiomyopathy: An Update

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    Uremic cardiomyopathy (UC) is the cardiac remodelling that occurs in patients with chronic kidney disease (CKD). It is characterised by a left ventricular (LV) hypertrophy phenotype, diastolic dysfunction and generally preserved LV ejection fraction. UC has a major role mediating the increased rate of cardiovascular events, especially heart failure related, observed in patients with CKD. Recently, the use of T1 and T2 mapping techniques on cardiac MRI has expanded the ability to characterise cardiac involvement in CKD. Native T1 mapping effectively tracks the progression of interstitial fibrosis in UC, whereas T2 mapping analysis suggests the contribution of myocardial oedema, at least in a subgroup of patients. Both T1 and T2 increased values were related to worsening clinical status, myocardial injury and B-type natriuretic peptide release. Studies investigating the prognostic relevance and histology validation of mapping techniques in CKD are awaited

    Exploring the influence of takotsubo syndrome on oncologic patients' mortality

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    It has been reported that patients affected by takotsubo syndrome (TTS) with a concurrent diagnosis of cancer suffer from greater mortality as compared to their non-cancer counterpart. It remains unclear whether TTS worsens the prognosis of cancer patients as well. Aim of this study was to compare outcomes of cancer patients with and without TTS. We combined data from two independent cohorts: one consisted of a prospective multicentre TTS registry; the second cohort consisted of all oncologic patients from two Cardio-Oncology Outpatient Clinics, who did not have cardiovascular conditions at the time of the cardio-oncologic visit. From the TTS registry, we selected patients with cancer (cancer-TTS patients). Next, we matched these patients with those from the cardio-oncologic cohort (cancer non-TTS patients) in a 1:2 fashion by age, sex, and type and cancer staging. Study endpoint was all-cause mortality. Among 318 TTS patients, 42 (13%) had a concurrent diagnosis of cancer. Characteristics of cancer-TTS patients and of the 84 matched cancer non-TTS subjects were comparable with the exception of diabetes mellitus, which was more common in cancer non-TTS patients. All-cause mortality was similar between cancer-TTS and cancer non-TTS patients. At Cox regression analysis TTS was not associated with mortality (OR 1.4, 95% CI 0.6-3.3, p = 0.43). Our findings show that even in the presence of acute heart failure due to TTS, the prognosis of oncologic patients is driven by the malignancy itself. Our results may prove useful for integrated management of cardio-oncologic patients

    Statin therapy and outcome in Takotsubo syndrome patients: Results from the multicenter international GEIST registry

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    Background and aims: Several studies have shown that endothelial dysfunction plays a role in the pathogenesis of Takotsubo syndrome (TTS). Given the potential benefit of statin therapy on endothelial dysfunction, we hypothesized that such treatment could improve outcome. Aim of our study was to evaluate clinical characteristics and outcome of TTS patients treated with statin therapy. Methods: Patients were enrolled in the international multicenter GEIST (GErman Italian Spanish Takotsubo) registry. Demographic data, clinical features and drug therapy at discharge were recorded. Primary study outcome was the occurrence of all-cause death at follow-up. Results: Study population included 2429 consecutive TTS patients: 1293 (53.2%) discharged on statin and 1136 (46.8%) without statin. Patients with statin were older (age 72 Â± 11 vs 69 Â± 13 years, p < 0.001), with higher prevalence of hypertension (74.3% vs 60.3%, p < 0.001), diabetes (21.1% vs 14.7%, p < 0.001), dyslipidemia (56.1% vs 23.3%, p < 0.001), history of coronary artery disease (13.3% vs 6.3%, p < 0.001) and lower rates of in-hospital complications (14.7% vs 19.3%, p = 0.003). Survival analysis showed similar mortality rates between groups (log rank p = 0.803). At univariable analysis, statin therapy at discharge was not associated with lower mortality (HR: 0.97, 95% CI 0.74-1.26, p = 0.803). At multivariable analysis age (HR: 1.06 95% CI 1.04-1.08, p < 0.001), male sex (HR: 1.83, 95% CI 1.20-2.80, p = 0.005), diabetes (HR: 2.55, 95% CI 1.83-3.54 p < 0.001), malignancies (HR: 2.41, 95% CI 1.68-3.44, p < 0.001) and physical trigger (HR: 2.24, 95% CI 1.62-3.10, p < 0.001) were associated with increased mortality. Conclusions: Statin therapy after a TTS event was not associated with better prognosis at follow-up

    Impact of intra-aortic balloon counterpulsation on all-cause mortality among patients with Takotsubo syndrome complicated by cardiogenic shock: results from the German-Italian-Spanish (GEIST) registry

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    Aims: Takotsubo syndrome (TTS) is an acute and reversible left ventricular dysfunction and can be complicated by cardiogenic shock (CS). However, few data are available on optimal care in TTS complicated by CS. Aim of this study was to evaluate short- and long-term impact of intra-aortic balloon pumping (IABP) on mortality in this setting. Methods and results: In a multi-centre, international registry on TTS, 2248 consecutive patients were enrolled from 38 centres from Germany, Italy, and Spain. Of the 2248 patients, 212 (9.4%) experienced CS. Patients with CS had a higher prevalence of diabetes (27% vs. 19%), male sex (25% vs. 10%), and right ventricular involvement (10% vs. 5%) (P < 0.01 in all cases). Forty-three patients with CS (20% of 212) received IABP within 8 h (interquartile range 4-18) after admission. No differences in terms of age, gender, cardiovascular risk factors, and admission left ventricular ejection fraction were found among patients with and without IABP. There were no significant differences in terms of 30-day mortality (16% vs. 17%, P = 0.98), length of hospitalization (18.9 vs. 16.7 days, P = 0.51), and need of invasive ventilation (35% vs. 41%, P = 0.60) among two groups: 30-day survival was not significantly different even after propensity score adjustment (log-rank P = 0.73). At 42-month follow-up, overall mortality in patients with CS and TTS was 35%, not significantly different between patients receiving IABP and not (37% vs. 35%, P = 0.72). Conclusions: In a large multi-centre observational registry, the use of IABP was not associated with lower mortality rates at short- and long-term follow-up in patients with TTS and CS

    Autorganizzazione e occupazioni abitative romane: una mappa (e un fenomeno) in movimento

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    Durante gli ultimi anni, diverse ricerche sono state realizzate a Roma sul tema dello spazio e dell’autorganizzazione e molte di queste contengono importanti mappature. Tuttavia, questi processi sono molto dinamici e la situazione a Roma cambia ogni anno. Per questa ragione a novembre 2017 abbiamo deciso di realizzare, per della conferenza “City and Self-organization”, tenutasi a Roma a dicembre 2017, un aggiornamento della situazione dell’autorganizzazione romana, legata all’utilizzo dello spazio, attraverso una mappa. Dopo aver ricostruito sinteticamente la storia di un lungo e radicato processo di lotta per la casa a Roma, ci siamo interrogati sull'efficacia delle occupazioni sul loro rapporto con le politiche urbane

    Management of Atrial Fibrillation in Pregnancy

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