Surgical site infection after caesarean section. Space for post-discharge surveillance improvements and reliable comparisons

Surgical site infections (SSI) after caesarean section (CS) represent a substantial health system concern. Surveying SSI has been associated with a reduction in SSI incidence. We report the findings of three (2008, 2011 and 2013) regional active SSI surveillances after CS in community hospital of the Latium region determining the incidence of SSI. Each CS was surveyed for SSI occurrence by trained staff up to 30 post-operative days, and association of SSI with relevant characteristics was assessed using binomial logistic regression. A total of 3,685 CS were included in the study. A complete 30 day post-operation follow-up was achieved in over 94% of procedures. Overall 145 SSI were observed (3.9% cumulative incidence) of which 131 (90.3%) were superficial and 14 (9.7%) complex (deep or organ/space) SSI; overall 129 SSI (of which 89.9% superficial) were diagnosed post-discharge. Only higher NNIS score was significantly associated with SSI occurrence in the regression analysis. Our work provides the first regional data on CS-associated SSI incidence, highlighting the need for a post-discharge surveillance which should assure 30 days post-operation to not miss data on complex SSI, as well as being less labour intensive

Colorectal Cancer Stage at Diagnosis Before vs During the COVID-19 Pandemic in Italy

IMPORTANCE Delays in screening programs and the reluctance of patients to seek medical attention because of the outbreak of SARS-CoV-2 could be associated with the risk of more advanced colorectal cancers at diagnosis. OBJECTIVE To evaluate whether the SARS-CoV-2 pandemic was associated with more advanced oncologic stage and change in clinical presentation for patients with colorectal cancer. DESIGN, SETTING, AND PARTICIPANTS This retrospective, multicenter cohort study included all 17 938 adult patients who underwent surgery for colorectal cancer from March 1, 2020, to December 31, 2021 (pandemic period), and from January 1, 2018, to February 29, 2020 (prepandemic period), in 81 participating centers in Italy, including tertiary centers and community hospitals. Follow-up was 30 days from surgery. EXPOSURES Any type of surgical procedure for colorectal cancer, including explorative surgery, palliative procedures, and atypical or segmental resections. MAIN OUTCOMES AND MEASURES The primary outcome was advanced stage of colorectal cancer at diagnosis. Secondary outcomes were distant metastasis, T4 stage, aggressive biology (defined as cancer with at least 1 of the following characteristics: signet ring cells, mucinous tumor, budding, lymphovascular invasion, perineural invasion, and lymphangitis), stenotic lesion, emergency surgery, and palliative surgery. The independent association between the pandemic period and the outcomes was assessed using multivariate random-effects logistic regression, with hospital as the cluster variable. RESULTS A total of 17 938 patients (10 007 men [55.8%]; mean [SD] age, 70.6 [12.2] years) underwent surgery for colorectal cancer: 7796 (43.5%) during the pandemic period and 10 142 (56.5%) during the prepandemic period. Logistic regression indicated that the pandemic period was significantly associated with an increased rate of advanced-stage colorectal cancer (odds ratio [OR], 1.07; 95%CI, 1.01-1.13; P = .03), aggressive biology (OR, 1.32; 95%CI, 1.15-1.53; P < .001), and stenotic lesions (OR, 1.15; 95%CI, 1.01-1.31; P = .03). CONCLUSIONS AND RELEVANCE This cohort study suggests a significant association between the SARS-CoV-2 pandemic and the risk of a more advanced oncologic stage at diagnosis among patients undergoing surgery for colorectal cancer and might indicate a potential reduction of survival for these patients

Empirical model for salinity assessment on lacustrine and coastal waters by remote sensing

The assessment of surface water salinity is a long standing feature request for water quality assessment by remote sensing. The aim of the present work is to test an empirical method for surface water salinity retrieval by means of multispectral satellite images at medium resolution (30 m). For this purpose, two case studies were selected: the first is Lake Qarun (Egypt), the second is an on-shore tract of central Adriatic Sea, located between the mouths of Tronto and Salinello Rivers (Italy). For the experimentation ALI (Advanced Land Imager) and Landsat ETM imagery was collected. Field data were acquired at both sites by means of in situ conductivity measurements, for calibration purpose. The model applied to convert atmospherically corrected reflectance value in practical salinity units (PSU) has been developed analysing the correlation between field data and an expressly defined salinity index. First results show a promising overall correlation (R2 = 0.85), even if further work is required to provide a better validation

Chagas, ten years of study in a public hospital

Background: Epidemiological study of chagasic patients in a public hospital between 2007 and 2017 Methods & Materials: All patients were evaluated with serological confirmation with two/three techniques (ELISA, TIF, HAI), cardiovascular(ECG, echocardiography, chest x-ray) and gastroenterological studies. The analyzed data were sex, age, place of birth, clinical staging, type of transmission, pregnancy condition, treatment and drug toxicity Results: Of 154 diagnosed, 34(22%) were males and 120(78%) were females, 68(56,6%) were pregnant at the time of diagnosis and 12(7,8%) they had been infected by mother-child transmission. The average age of infected women was 37.3(range 15-66) and in men was 55,8(range 13-73). Of all diagnosed, 29(19%) had cardiovascular and 6(3,9%) gastrointestinal diseases. Almost half are from bordering countries(Bolivia, Paraguay) Of our country, Chaco was the one that more number of cases contribute. They received treatment in accordance with the recommendations of the Ministry of Health 62 (40,3%) and 11(17,8%) of them evidenced drug toxicity. Conclusion: More women than men were diagnosed. Almost 60% during pregnancy. The cardiovascular affectation was diagnosed five times more than the gastrointestinal disease. Only 40% of those diagnosed were included in the treatment criteria.Facultad de Ciencias Médica

Chondrocalcinosis: A morphofunctional study of crystal deposition in mechanically stressed shoulder soft tissues

Introduction: Chondrocalcinosis is a pathological condition characterized by the presence of calcium pyrophosphate dihydrate (CPPD) crystal deposition in the soft tissues. Even if knee articular cartilage is the most involved anatomical area, different kind of tissue and joint can be affected by this disorder. Methods: The aim of this manuscript is to analyze at histological and ultrastructural level the crystal deposition in shoulder soft tissue subjected to mechanical stress of patients affected by CPPD disease. Moreover, the cellular behavior in the same specimens has been investigated by means of transmission electron microscopy at variable distances from crystal deposits. Results: An interesting relationship between CPPD and cellular impairment appears in humeral articular cartilage, joint capsule and long head of biceps brachii tendon sheath, where respectively chondrocytes and fibroblasts, close to crystal deposits, reveal numerous cell damages, such as chromatin condensation, dilation of organelles orcell membrane rupture. Conclusion: Considering that cells far to the crystals are healthy, their behavior appears to be different from that of neighboring cells, then our preliminary results suggest a possible cause-effect relationship between events. Level of evidence: basic science study

Benthic foramiferal evidence for the formation of the Holocene mud belt and bathymetrical evolution in the central Adriatic Sea.

none10Detailed analyses of modern and fossil benthic foraminiferal assemblages collected in the central Adriatic Sea are used as tools to reconstruct the environmental changes that occurred between the Last Deglaciation and the Present (last 14 Kyrs); in particular we focus on the timing and formation of the mud-belt. The modern benthic foraminiferal assemblages display a parallel zonation to the Italian coast controlled by the interaction between food/oxygen availability and water depth. Cluster analysis of 4 sediment cores separates the fossil foraminiferal assemblages in 6 groups: Cluster A is dominated by three Ammonia species; Cluster B consists of Ammonia papillosa, Nonionella turgida, Elphidium advenum and Elphidium decipiens; Cluster C is composed of two taxa, Hyalinea balthica and Trifarina angulosa; Cluster D is dominated by 5 species, Cibicides lobatulus, Buccella granulata, Reussella spinulosa, Textularia agglutinans and Elphidium crispum; Cluster E contains Bulimina spp., Gavelinopsis praegeri, Bolivina spp., Cassidulina neocarinata and Asterigerinata mamilla; and Cluster F is dominated by Bulimina marginata, Valvulineria bradyana, Globocassidulina subglobosa and Melonis padanum. The cluster analysis and contemporary distribution patterns of these taxa are used together with ecological preferences of the most frequent species to reconstruct the spatial and temporal distribution of the different biofacies in the past. This reveals information about Holocene palaeoenvironmental changes that are related to water depth fluctuations and the installment of the coast-parallel mud-belt. The benthic assemblage records the transition from a infralitoral environment (Biofacies I) to deeper marine condition (Biofacies III). After that the sea level reached about the modern level (Biofacies IV) the benthic foraminiferal community evidences the development of the mud-belt and the subsequent transformation of the ecological niches linked to the trophic evolution of the environment.noneMORIGI C.; JORISEN F. J.; FRATICELLI S.; HORTON B. P.; PRINCIPI M.; SABATINI A.; CAPOTONDI L.; CURZI P.V.; NEGRI A.; (2005).MORIGI C.; JORISEN F. J.; FRATICELLI S.; HORTON B. P.; PRINCIPI M.; SABATINI A.; CAPOTONDI L.; CURZI P.V.; NEGRI A.; (2005)