Preoperative smoking cessation program in patients undergoing intermediate to high-risk surgery: a randomized, single-blinded, controlled, superiority trial

BACKGROUND At present, effectively implementing smoking cessation programs in the health care system constitutes a major challenge. A unique opportunity to initiate smoking cessation focuses on smokers scheduled for surgery. These patients are not only highly motivated to quit smoking but also likely to benefit from a reduction in postoperative complications which may translate into a decrease of costs. Nevertheless, surgical patients are not routinely informed about the benefits of preoperative smoking cessation. Potential reasons for this missed opportunity may be the lack of time and training of surgeons and anaesthesiologists. We therefore aim to analyse the impact of a preoperative high-intensity smoking cessation intervention on surgical complications up to a 90-day postoperative period in patients of various surgical disciplines. The hypothesis is that a preoperative smoking cessation program improves outcomes in smokers undergoing intermediate to high-risk surgery. METHODS The present study is a single-centre, randomized trial with two parallel groups of smokers scheduled for surgery comparing surgery alone and surgery with preoperative smoking cessation. We plan to randomize 251 patients. The primary objective is to compare complications between patients with an institutional multifaceted smoking cessation intervention starting 4 weeks before surgery compared to patients in the advice-only group (control group) within a 90-day postoperative period. The primary endpoint is the Comprehensive Complication Index (CCI®) within 90 days of surgery. Secondary outcomes include the length of hospital stay, cost of care, quality of life, smoking abstinence, and reduction in nicotine consumption. DISCUSSION The hypothesis is that a preoperative smoking cessation program improves outcomes in smokers undergoing surgery. TRIAL REGISTRATION BASEC #2021-02004; ClinicalTrials.gov: NCT05192837 . Registered on January 14, 2022

Agricoltura e allevamento nell’Italia medievale. Contributo bibliografico, 1950-2010

The bibliography proposed takes into account the historiographical works on Middle Ages (VI-XV centuries) of the years 1950-2010: these are years particularly significant for the development and consolidation of studies relating to Italian (and more generally European) agricultural history. In order to facilitate the consultation, the work is organized into chapters and thematic sections, preceded by a brief explanatory note which gives an account of the criteria used to identify the listed works. The Introduction presents thoughts on the salient moments of the historiographical history at the heart of the contemporary discussion.Il contributo bibliografico proposto considera la produzione storiografica di riferimento medievale (secoli VI-XV) degli anni 1950-2010: sessant’anni particolarmente significativi per lo sviluppo e il consolidamento degli studi relativi alla storia agraria italiana (e pi\uf9 generalmente europea). Al fine di agevolare la ricerca, \ue8 organizzato in capitoli e sezioni tematiche, preceduti da una breve nota esplicativa che rende conto dei criteri utilizzati per l’individuazione delle opere in elenco. Nell’Introduzione si sviluppano riflessioni sui momenti salienti della vicenda storiografica al centro dell’attenzione

In ricordo di Renato Bordone

Saggio storiografico dedicato alla figura di un grande medievista italiano recentemente scomparso

Biblioteca di Storia agraria medievale.

La principale collana italiana di storia agraria medievale

Human-derived landscape changes on the northern Etruria coast (western Italy) between Roman times and the late Middle Ages

Anthracological analysis has been carried out in three sites located on the Tyrrhenian coast of central Italy (ancient northern Etruria: the castle of Donoratico, the town of Populonia and the port of Alberese), spanning between the Roman Republican Period and the Late Middle Ages (3rd century BC???13th century AD). The integrated comparison of three different local charcoal data with the regional pollen and microcharcoal data available from northern Etruria showed well that vegetation changes are completely independent of climate and strictly connected to economic and social dynamics characterising the history of this part of central Italy. Indeed, Quercus ilex forests progressively retracted from the 3rd century BC in favour of open macchia formations just during the growing human impact of the Romanisation when intensive agriculture and livestock grazing characterised the economic system. The transition from macchia to deciduous Quercus forest at the end of the Roman Period from the mid-4th to the mid-5th centuries AD and long lasting until the 9th???10th centuries AD was related to economic and cultural factors which led to a phase of land abandonment. Finally, between the 11th and 13th centuries AD, the vegetation cover shifted again towards an open macchia environment at the same time of a re-settlement phase well evidenced also by intensive orcharding. Charcoal data also showed that the expansion of olive and chestnut in central Italy only began in the Late Medieval Period (11th century AD) and not in the Roman Period. This means that extensive cultivation of chestnut and olive has very recent origins and should be attributed to one and the same macro-factor such as the set-up of the economic establishment of the feudal system and the later political organism of the Medieval town