Thoracic surgery in the COVID-19 era: an Italian university hospital experience

BackgroundAims of this study were to assess the results of anti-COVID19 measures applied to maintain thoracic surgery activity at an Italian University institution through a 12-month period and to assess the results as compared with an equivalent non-pandemic time span.MethodsData and results of 646 patients operated on at the department of Thoracic Surgery of the Tor Vergata University Policlinic in Rome between February 2019 and March 2021 were retrospectively analyzed. Patients were divided in 2 groups: one operated on during the COVID-19 pandemic (pandemic group) and another during the previous non-pandemic 12 months (non-pandemic group). Primary outcome measure was COVID-19 infection-free rate.ResultsThree patients developed mild COVID-19 infection early after surgery resulting in an estimated COVID-19 infection-free rate of 98%. At intergroup comparisons (non-pandemic vs. pandemic group), a greater number of patients was operated before the pandemic (352 vs. 294, p = 0.0013). In addition, a significant greater thoracoscopy/thoracotomy procedures rate was found in the pandemic group (97/151 vs. 82/81, p = 0.02) and the total number of chest drainages (104 vs. 131, p = 0.0001) was higher in the same group. At surgery, tumor size was larger (19.5 13 vs. 28.2 +/- 21; p < 0.001) and T3-T4/T1-T2 ratio was higher (16/97 vs. 30/56; p < 0.001) during the pandemic with no difference in mortality and morbidity. In addition, the number of patients lost before treatment was higher in the pandemic group (8 vs. 15; p = 0.01). Finally, in 7 patients admitted for COVID-19 pneumonia, incidental lung (N = 5) or mediastinal (N = 2) tumors were discovered at the chest computed tomography.Conclusions Estimated COVID-19 infection free rate was 98% in the COVID-19 pandemic group; there were less surgical procedures, and operated lung tumors had larger size and more advanced stages than in the non-pandemic group. Nonetheless, hospital stay was reduced with comparable mortality and morbidity. Our study results may help implement efficacy of the everyday surgical care

Tumor type M2-pyruvate-kinase levels in pleural fluid versus plasma in cancer patients: a further tool to define the need for invasive procedures

Pleural effusion is a common diagnostic problem and a challenge to the thoracic surgeon. The analysis of serum and body fluids for tumor markers is an established diagnostic procedure. Among various markers, tumors are linked to the overexpression of a glycolytic isoenzyme, M2-pyruvate-kinase (M2-PK). This preliminary study evaluated this enzyme as a tumor marker to differentiate malignant from benign pleural effusion

Invasive infections due to Streptococcus pyogenes: seasonal variation of severity and clinical characteristics, Iceland, 1975 to 2012.

To access publisher's full text version of this article click on the hyperlink at the bottom of the pageEpidemiology and clinical characteristics of invasive Group A streptococcal infections (IGASI) are highly variable. Long-term studies are needed to understand the interplay between epidemiology and virulence. In a population-based study of IGASI in Iceland from 1975 to 2012, 288 cases were identified by positive cultures from normally sterile body sites. Charts were reviewed retrospectively and emm-types of viable Streptococcus pyogenes isolates (n=226) determined. Comparing the first and last decade of the study period, IGASI incidence increased from 1.09 to 3.96 cases per 100,000 inhabitants per year. The most common were emm types 1 (25%), 28 (11%) and 89 (11%); emm1 strains were most likely to cause severe infections. Infections in adults were significantly more likely to be severe during the seasonal peak from January to April (risk ratio: 2.36, 95% confidence interval: 1.34–4.15). Significant seasonal variability in severity was noted among patients with diagnosis of sepsis, respiratory infection and cellulitis, with 38% of severe infections in January to April compared with 16% in other months (p<0.01). A seasonal increase in severity of IGASI suggested that generalised seasonal increase in host susceptibility, rather than introduction of more virulent strains may play a role in the pathogenesis of these potentially fatal infections.Icelandic Center for Research, Rannis/100436021 Landspitali University Hospital Science Fun

Cocaína e crack: efeitos no sistema cardiovascular

O aumento do consumo de entorpecentes opióides derivados da folha de coca, como a cocaína e o crack, levou ao crescimento do número de casos de doenças sistêmicas, em especial no sistema cardiovascular. Tendo em vista essa problemática, este grupo de acadêmicos do segundo módulo do curso de medicina do UniFOA, se propõe a abordar o tema de maneira sucinta e objetiva a ser compreendida por estudantes universitários dos cursos de ciências biológicas e da saúde; ciências humanas e sociais aplicadas; engenharias, exatas e tecnológicas. A exposição do projeto se dará na forma de apresentação em Power Point com explicações orais. Os dados serão obtidos através da pesquisa em livros de referência, artigos acadêmicos e científicos, revistas de grande circulação e em sites com relevância autoral. O projeto abordará os efeitos fisiológicos e patológicos dessas substâncias supracitadas, além de correlacioná-las dentro de um contexto histórico e social dando enfoque nos aspectos clínicos

Problems with Saliency Maps

Despite the popularity that saliency models have gained in the computer vision community, they are most often conceived, exploited and benchmarked without taking heed of a number of problems and subtle issues they bring about. When saliency maps are used as proxies for the likelihood of fixating a location in a viewed scene, one such issue is the temporal dimension of visual attention deployment. Through a simple simulation it is shown how neglecting this dimension leads to results that at best cast shadows on the predictive performance of a model and its assessment via benchmarking procedures

How to look next? A data-driven approach for scanpath prediction

By and large, current visual attention models mostly rely, when considering static stimuli, on the following procedure. Given an image, a saliency map is computed, which, in turn, might serve the purpose of predicting a sequence of gaze shifts, namely a scanpath instantiating the dynamics of visual attention deployment. The temporal pattern of attention unfolding is thus confined to the scanpath generation stage, whilst salience is conceived as a static map, at best conflating a number of factors (bottom-up information, top-down, spatial biases, etc.). In this note we propose a novel sequential scheme that consists of a three-stage processing relying on a center-bias model, a context/layout model, and an object-based model, respectively. Each stage contributes, at different times, to the sequential sampling of the final scanpath. We compare the method against classic scanpath generation that exploits state-of-the-art static saliency model. Results show that accounting for the structure of the temporal unfolding leads to gaze dynamics close to human gaze behaviour

Neuroinflammation, Mast Cells, and Glia: Dangerous Liaisons

The perspective of neuroinflammation as an epiphenomenon following neuron damage is being replaced by the awareness of glia and their importance in neural functions and disorders. Systemic inflammation generates signals that communicate with the brain and leads to changes in metabolism and behavior, with microglia assuming a pro-inflammatory phenotype. Identification of potential peripheral-to-central cellular links is thus a critical step in designing effective therapeutics. Mast cells may fulfill such a role. These resident immune cells are found close to and within peripheral nerves and in brain parenchyma/meninges, where they exercise a key role in orchestrating the inflammatory process from initiation through chronic activation. Mast cells and glia engage in crosstalk that contributes to accelerate disease progression; such interactions become exaggerated with aging and increased cell sensitivity to stress. Emerging evidence for oligodendrocytes, independent of myelin and support of axonal integrity, points to their having strong immune functions, innate immune receptor expression, and production/response to chemokines and cytokines that modulate immune responses in the central nervous system while engaging in crosstalk with microglia and astrocytes. In this review, we summarize the findings related to our understanding of the biology and cellular signaling mechanisms of neuroinflammation, with emphasis on mast cell-glia interactions

Адаптация гидравлической модели водостока к бассейнам рек Дунай и Днестр

Гидравлическая модель водостока адаптирована к бассейну рек Дунай и Днестр. По данным орографии, атмосферных осадках или поверхностном стоке она позволяет рассчитывать объемы, расходы и уровни воды с пространственным разрешением 1 км. В модели возможно использование данные об экосистемах на земной поверхности, типах почвы. По данным наблюдений стока оценены среднемесячные величины расходов рек, которые соответствуют наблюдениям, что позволяет применять модель в дальнейших оценках стока, наносов и т.д.Hydraulic model of water inflow is adapted to the Danube and the Dniester rivers basin. According to the orography, precipitation and surface inflow data it permits to calculate water volumes, discharges and levels with spatial resolution 1 km. It is possible to use the data on ecosystems on the ground surface, types of soil in the model. According to the observations data of the inflow the average monthly values of river discharges corresponding to the observations are estimated. It permits to apply the model in the further estimations of inflow, alluvia e t.c