Gender Differences in Er Psychiatric Consultations Among Suicide Attempters

Purpose: Suicide attempts are extremely prevalent and associated with many risk factors that vary with age and gender, occur in combination, and may change over time. The aim of the present study was to describe gender differences among psychiatric ER users at the AOU Maggiore della Carità Hospital in Novara for attempted suicide with regard to intentions and methods of attempting. Methods: Determinants of ER psychiatric consultations were studied prospectively during the period 2008- 2014 at the 'Maggiore” Hospital in Novara. Comparison of qualitative data was performed by means of the χ2 test. Statistical significance was set at p≤0.05. Results: We have already gathered data from more than 2000 ER psychiatric consultations. Preliminary results suggest that suicide attempts are more common in females than in males, although through the years there seems to be a trend towards increase of attempts even in males. Surprisingly, suicide attempts are found to be more common in employed subjects than in unemployed ones. Reasons for self-harming are associated with relational problems rather than psychiatric symptoms. Drugs poisoning seems to be the preferred suicide method. Conclusions: The results described above should be considered as preliminary, as data collection and statistical analyses are still ongoing. Anyway, the possible correlation between employment and suicide attempt, and the growing frequency of attempts in males seem to be particularly interesting. Implications will be discussed

Multi-segment rupture of the 2016 Amatrice-Visso-Norcia seismic sequence (central Italy) constrained by the first high-quality catalog of Early Aftershocks

We present the first high-quality catalog of early aftershocks of the three mainshocks of the 2016 central Italy Amatrice-Visso-Norcia normal faulting sequence. We located 10,574 manually picked aftershocks with a robust probabilistic, non-linear method achieving a significant improvement in the solution accuracy and magnitude completeness with respect to previous studies. Aftershock distribution and relocated mainshocks give insight into the complex architecture of major causative and subsidiary faults, thus providing crucial constraints on multi-segment rupture models. We document reactivation and kinematic inversion of a WNW-dipping listric structure, referable to the inherited Mts Sibillini Thrust (MST) that controlled segmentation of the causative normal faults. Spatial partitioning of aftershocks evidences that the MST lateral ramp had a dual control on rupture propagation, behaving as a barrier for the Amatrice and Visso mainshocks, and later as an asperity for the Norcia mainshock. We hypothesize that the Visso mainshock re-activated also the deep part of an optimally oriented preexisting thrust. Aftershock patterns reveal that the Amatrice Mw5.4 aftershock and the Norcia mainshock ruptured two distinct antithetic faults 3-4 km apart. Therefore, our results suggest to consider both the MST cross structure and the subsidiary antithetic fault in the finite-fault source modelling of the Norcia earthquake.Published69214T. Sismicità dell'ItaliaJCR Journa

Catalogo completo della sequenza sismica di Amatrice-Visso-Norcia (Italia centrale, Bollettino Sismico Italiano 2016-2018)

In questo lavoro presentiamo il catalogo completo delle localizzazioni dei terremoti appartenenti alla più importante sequenza sismica avvenuta in Italia negli ultimi 30 anni, ovvero la sequenza sismica di Amatrice-Visso-Norcia (AVN) iniziata il 24 Agosto del 2016 in Appennino centrale. Si tratta di 102582 eventi sismici registrati dalle 129 stazioni della Rete Sismica Nazionale (RSN, http://doi.org/10.13127/SD/X0FXNH7QFY) e della rete temporanea installata nella regione epicentrale (Moretti et al., 2016), dal 14 agosto 2016 al 31 agosto 2018 e analizzati manualmente dagli analisti del Bollettino Sismico Italiano (BSI, http://cnt.rm.ingv.it/bsi). Le fasi P ed S e le ampiezze di questi terremoti, stimate in tempo reale nella sala di sorveglianza dell’Istituto Nazionale di Geofisica e Vulcanologia (INGV) di Roma, sono state successivamente riviste in dettaglio, per tutti gli eventi di M≽ 2.3, con l’intento di aumentare la qualità dei parametri di localizzazione e della stima della magnitudo. Gli analisti hanno inoltre inserito le fasi P ed S osservate a quelle stazioni che il sistema di acquisizione non aveva eventualmente incluso nelle soluzioni automatiche in real-time. Per i primi mesi della sequenza l'analisi ha riguardato anche l’integrazione delle registrazioni di 9 stazioni temporanee standalone che non entravano automaticamente nelle localizzazioni della sala sismica; per i giorni nei quali si sono verificati gli eventi di M≽ 5.5 la revisione è stata particolarmente accurata anche per eventi di magnitudo inferiore a 2.3 (Improta et al. 2019) Il dataset così costruito consiste in 25496 terremoti rivisti dagli analisti del bollettino (versione 1000) e 77426 eventi elaborati dai turnisti in sala sismica (versione 100). Le 1705987 fasi P che ne sono derivate, e le 1271757 fasi S, sono disponibili nel database ISIDe (DOI: 10.13127/ISIDe). Tutte le letture dei tempi di arrivo sono state utilizzate per localizzare gli ipocentri della sequenza utilizzando il codice di inversione non lineare NonLinLoc (NLL, Lomax et al., 2001): l’utilizzo di questa tecnica ha migliorato, rispetto ai lavori precedenti, la stima dei parametri ipocentrali fornendo delle soluzioni più robuste ai fini della ricostruzione sismotettonica dell’area interessata dalla sequenza sismica AVN. Rispetto ai dati forniti in tempo reale dal personale in servizio di sorveglianza sismica dell’INGV, questo nuovo catalogo presenta un notevole miglioramento in termini di omogeneità della stima della ML, almeno nel range definito dalla soglia inferiore di revisione pari a ML≽ 2.3. Questa maggiore omogeneità del catalogo permetterà ulteriori analisi per la stima della Mc (Magnitudo di completezza). Inoltre, all’interno del catalogo sono presenti 75 terremoti con ML≽4.0: per 47 di questi eventi sismici abbiamo calcolato il meccanismo focale a partire dalle prime polarità utilizzando il codice FPFIT (Reasenberg and Oppenheimer, 1985). Un catalogo di questo tipo, di alta qualità, basato quindi su un imponente numero di fasi e ampiezze riviste manualmente, ha una particolare importanza e può essere un valido riferimento per l’applicazione per esempio di tecniche di detection basate sulla crosscorrelazione di registrazioni di terremoti templates, per la validazione di cataloghi composti da letture automatiche dei tempi di arrivo, o anche per l’ottimizzazione di algoritmi di picking automatici. La qualità delle localizzazioni dei mainshocks e degli aftershocks della sequenza sismica AVN diventa fondamentale per capire l'analisi dell'evoluzione spazio-temporale della sismicità, anche di bassa magnitudo, e le complesse geometrie delle faglie attivate durante la sequenza sismica, contestualmente alle relazioni tra esse esistenti.PublishedRoma - Italia4IT. Banche dat

Baseline Plasma Osteopontin Protein Elevation Predicts Adverse Outcomes in Hospitalized COVID-19 Patients

More than three years have passed since the first case, and COVID-19 is still a health concern, with several open issues such as the lack of reliable predictors of a patient's outcome. Osteopontin (OPN) is involved in inflammatory response to infection and in thrombosis driven by chronic inflammation, thus being a potential biomarker for COVID-19. The aim of the study was to evaluate OPN for predicting negative (death or need of ICU admission) or positive (discharge and/or clinical resolution within the first 14 days of hospitalization) outcome. We enrolled 133 hospitalized, moderate-to-severe COVID-19 patients in a prospective observational study between January and May 2021. Circulating OPN levels were measured by ELISA at admission and at day 7. The results showed a significant correlation between higher plasma concentrations of OPN at hospital admission and a worsening clinical condition. At multivariate analysis, after correction for demographic (age and gender) and variables of disease severity (NEWS2 and PiO2/FiO2), OPN measured at baseline predicted an adverse prognosis with an odds ratio of 1.01 (C.I. 1.0-1.01). At ROC curve analysis, baseline OPN levels higher than 437 ng/mL predicted a severe disease evolution with 53% sensitivity and 83% specificity (area under the curve 0.649, p = 0.011, likelihood ratio of 1.76, (95% confidence interval (CI): 1.35-2.28)). Our data show that OPN levels determined at the admission to hospital wards might represent a promising biomarker for early stratification of patients' COVID-19 severity. Taken together, these results highlight the involvement of OPN in COVID-19 evolution, especially in dysregulated immune response conditions, and the possible use of OPN measurements as a prognostic tool in COVID-19

New national and regional Annex I Habitat records: from #26 to #36

New Italian data on the distribution of the Annex I Habitats 1510*, 2130*, 2250*, 3180*, 3260, 5230*, 6410, 7140, 7220*, 9320 are reported in this contribution. Specifically, 14 new occurrences in Natura 2000 sites are presented and 20 new cells are added in the EEA 10 km × 10 km reference grid. The new data refer to the Italian administrative regions of Abruzzo, Apulia, Friuli Venezia Giulia, Liguria, Marche, Molise, Sardinia, Sicily, Tuscany and Umbria

Outcomes of COVID-19 patients treated with continuous positive airway pressure outside ICU

Aim We aim at characterizing a large population of Coronavirus 19 (COVID-19) patients with moderate-to-severe hypoxemic acute respiratory failure (ARF) receiving CPAP outside intensive care unit (ICU), and ascertaining whether the duration of CPAP application increased the risk of mortality for patients requiring intubation. Methods In this retrospective, multicentre cohort study, we included COVID-19 adult patients, treated with CPAP outside ICU for hypoxemic ARF from March 1 st to April 15th, 2020. We collected demographic and clinical data, including CPAP therapeutic goal, hospital length of stay (LOS), and 60- day in-hospital mortality. Results The study includes 537 patients with a median age of 69 (IQR, 60-76) years. Males were 391 (73%). According to predefined CPAP therapeutic goal, 397 (74%) patients were included in full treatment subgroup, and 140 (26%) in the do-not intubate (DNI) subgroup. Median CPAP duration was 4 (IQR, 1-8) days, while hospital LOS 16 (IQR, 9-27) days. Sixty-day in-hospital mortality was overall 34% (95%CI, 0.304-0.384), and 21% (95%CI, 0.169-0.249) and 73% (95%CI, 0.648-0.787) for full treatment and DNI subgroups, respectively. In the full treatment subgroup, in-hospital mortality was 42% (95%CI, 0.345-0.488) for 180 (45%) CPAP failures requiring intubation, while 2% (95%CI, 0.008- 0.035) for the remaining 217 (55%) patients who succeeded. Delaying intubation was associated with increased mortality [HR, 1.093 (95%CI, 1.010-1.184)]. Conclusions We described a large population of COVID-19 patients treated with CPAP outside ICU. Intubation delay represents a risk factor for mortality. Further investigation is needed for early identification of CPAP failures

Immune signatures in human PBMCs of idiotypic vaccine for HCV-related lymphoproliferative disorders

Hepatitis C virus (HCV) is one of the major risk factors for chronic hepatitis, which may progress to cirrhosis and hepatocellular carcinoma, as well as for type II mixed cryoglobulinemia (MC), which may further evolve into an overt B-cell non-Hodgkin's lymphoma (NHL)

Beta-Blocker Use in Older Hospitalized Patients Affected by Heart Failure and Chronic Obstructive Pulmonary Disease: An Italian Survey From the REPOSI Register

Beta (β)-blockers (BB) are useful in reducing morbidity and mortality in patients with heart failure (HF) and concomitant chronic obstructive pulmonary disease (COPD). Nevertheless, the use of BBs could induce bronchoconstriction due to β2-blockade. For this reason, both the ESC and GOLD guidelines strongly suggest the use of selective β1-BB in patients with HF and COPD. However, low adherence to guidelines was observed in multiple clinical settings. The aim of the study was to investigate the BBs use in older patients affected by HF and COPD, recorded in the REPOSI register. Of 942 patients affected by HF, 47.1% were treated with BBs. The use of BBs was significantly lower in patients with HF and COPD than in patients affected by HF alone, both at admission and at discharge (admission, 36.9% vs. 51.3%; discharge, 38.0% vs. 51.7%). In addition, no further BB users were found at discharge. The probability to being treated with a BB was significantly lower in patients with HF also affected by COPD (adj. OR, 95% CI: 0.50, 0.37-0.67), while the diagnosis of COPD was not associated with the choice of selective β1-BB (adj. OR, 95% CI: 1.33, 0.76-2.34). Despite clear recommendations by clinical guidelines, a significant underuse of BBs was also observed after hospital discharge. In COPD affected patients, physicians unreasonably reject BBs use, rather than choosing a β1-BB. The expected improvement of the BB prescriptions after hospitalization was not observed. A multidisciplinary approach among hospital physicians, general practitioners, and pharmacologists should be carried out for better drug management and adherence to guideline recommendations

Fatality rate and predictors of mortality in an Italian cohort of hospitalized COVID-19 patients

Clinical features and natural history of coronavirus disease 2019 (COVID-19) differ widely among different countries and during different phases of the pandemia. Here, we aimed to evaluate the case fatality rate (CFR) and to identify predictors of mortality in a cohort of COVID-19 patients admitted to three hospitals of Northern Italy between March 1 and April 28, 2020. All these patients had a confirmed diagnosis of SARS-CoV-2 infection by molecular methods. During the study period 504/1697 patients died; thus, overall CFR was 29.7%. We looked for predictors of mortality in a subgroup of 486 patients (239 males, 59%; median age 71 years) for whom sufficient clinical data were available at data cut-off. Among the demographic and clinical variables considered, age, a diagnosis of cancer, obesity and current smoking independently predicted mortality. When laboratory data were added to the model in a further subgroup of patients, age, the diagnosis of cancer, and the baseline PaO2/FiO2 ratio were identified as independent predictors of mortality. In conclusion, the CFR of hospitalized patients in Northern Italy during the ascending phase of the COVID-19 pandemic approached 30%. The identification of mortality predictors might contribute to better stratification of individual patient risk