ANALISI DELL¿ATTIVITÀ DI SCREENING DEL COLON RETTO NELL'ASL MILANO 1 (2006-12)

Objective Colorectal cancer is one of the main challenges in public health: it is cancer with higher incidence in Western society, and is available for its early diagnosis a screening test which can be followed a treatment effective. In particular, Europe countries in the last decade have developed screening programs. A program was developed in Asl Milano 1 (Lombardia \u2013 Italy) from 2006 to nowadays. The objective of the study is to analyze the overall performance of colon rectal screening in ASL Milano 1 in the period 2006-12 Methods Every two years, 50\u201369 year olds receive a letter from Asl Milano 1 that invite them to go in a pharmacy and take a FOBT-kit (fecal occult blood test). People complete the test in the privacy of their own home. Kit must be reported in a pharmacy that sent it to the laboratory for analysis. Negative people is informed about test result by mail. Positive people is usually informed by a telephone call by a nurse of his health territorial unit that recommend a colonoscopy and book one in an hospital. Participation in the program is voluntary and there is no cost involved in completing the test or colonoscopy. Quality-assurance requirements were established to ensure safe procedures and practice in every clinical aspect of a screening-program Results From 2006 to 2012 a total of 722.605 individuals were invited to screening , 274.167 returned with a correctly placed stool specimen on FOBT cards, 565 and 3344 High risk adenoma were identified . Some indicator were calculated(reported only last year- 2011): subjects invited 91%, crude compliance 45%; adjusted adherence 46%; delay between FOBT screening and negative result 99% within 21 days; Positivity rate 5,4%; participation to colonoscopy 90%; complete colonoscopy rate 93%; Delay between the call for colonoscopy and the colonoscopy procedure ; 61% within 60 calendar days ; positive predictive value of FOBT at colonoscopy 3,1% for cancer and 21,9 %for high risk adenoma; 1/3 of cancers screen-detected are T1; sensibility 86% (IC 95% 83-89) specificity 97%. Conclusion The screening program has provided the public with a service that meets the needs and sustainable over the years. Limit in the organizational process is the waiting time for the provision of colonoscopy: impact significantly on the ability to increase screening performaces. iFOBT-based screening programmes showed a high performance in terms of sensitivity as estimated through the interval cancers rates

Modeling the Epidemic Outbreak and Dynamics of COVID-19 in Croatia

The paper deals with a modeling of the ongoing epidemic caused by Coronavirus disease 2019 (COVID-19) on the closed territory of the Republic of Croatia. Using the official public information on the number of confirmed infected, recovered and deceased individuals, the modified SEIR compartmental model is developed to describe the underlying dynamics of the epidemic. Fitted modified SEIR model provides the prediction of the disease progression in the near future, considering strict control interventions by means of social distancing and quarantine for infected and at-risk individuals introduced at the beginning of COVID-19 spread on February, 25th by Croatian Ministry of Health. Assuming the accuracy of provided data and satisfactory representativeness of the model used, the basic reproduction number is derived. Obtained results portray potential positive developments and justify the stringent precautionary measures introduced by the Ministry of Health.Comment: 5 pages, 6 figures, to appear in the Proceedings of the SpliTech2020 conferenc

Proteoglycan neofunctions: regulation of inflammation and autophagy in cancer biology.

Inflammation and autophagy have emerged as prominent issues in the context of proteoglycan signaling. In particular, two small, leucine-rich proteoglycans, biglycan and decorin, play pivotal roles in the regulation of these vital cellular pathways and, as such, are intrinsically involved in cancer initiation and progression. In this minireview, we will address novel functions of biglycan and decorin in inflammation and autophagy, and analyze new emerging signaling events triggered by these proteoglycans, which directly or indirectly modulate these processes. We will critically discuss the dual role of proteoglycan-driven inflammation and autophagy in tumor biology, and delineate the potential mechanisms through which soluble extracellular matrix constituents affect the microenvironment associated with inflammatory and neoplastic diseases

Inferior vena cava and pulmonary artery diameters for prognosis of Coronavirus disease

Aim: In this study, we aimed to analyze the relationship between pulmonary artery (PA) and inferior vena cava (IVC) diameters in non-contrast chest computerized tomography (CT) images of patients with coronavirus disease 2019 (COVID-19) and overall survival. Material and Methods: This retrospective study consisted of 404 consecutive patients who underwent chest CT after admission to the emergency department between May 1 and June 31. 2021. CT measurements were performed by two radiologists. The prognostic value of PA and IVC diameters, the computerized tomography severity score (CT-55), quick sequential organ failure assessment (qSOFA), and confusion, urea, respiratory rate, blood pressure, and age >= years (CURB-65) score on overall survival were examined. Results: The median age of the participants was 62 years (49-72), and 196 (48.5%) were male. Of the 404 patients, 61 died after admission. While main-PA, left-PA, right-PA (p < 0.001) and NC-transverse (IVC-Tr) (p = 0.045) diameters were larger and statistically significant in the patients who died (AUC; 0.686, 0.722, 0.746, and 0.581, respectively), a statistically significant difference was not detected in terms of IVC anteroposterior diameter (IVC-AP) (p = 0.053) and the IVC-Tr/AP (p = 0.754) ratio. There was a statistical difference in mortality in ciSOFA, CURB-65, and CT-SS values (AUC; 0.727, 0.798, and 0.708 p < 0.001, respectively). Discussion: PA diameters measured from chest CT images at admission (main-PA >= 26.5 mm, right-PA >= 22.9 mm, and left-PA >= 21.6 mm) and the IVC-Tr diameter (>= 34.5 mm) can be used as mortality predictors for COVID-19, along with other prognostic scores

ASSESSMENT OF THE CORRELATION BETWEEN COVID-19 PNEUMONIA SEVERITY AND PULMONARY ARTERY DIAMETER MEASUREMENT WITH COMPUTED TOMOGRAPHY SCAN

Objective: This consideration used the computed tomography scan to investigate and evaluate relationship between COVID-19 pneumonia severity and pulmonary artery diameter, ascending aorta diameter (AAD), right and left pulmonary artery diameter (LPAD), and ratio of main pulmonary artery diameter (MPAD) to AAD in COVID-19 patients. Methods: This retrospective and cross-sectional consideration was done on 90 confirmed COVID-19 patients. Diameter of MPAD, AAD, LPAD, and right pulmonary artery diameter was calculated on a solitary transverse section designated at extent of main pulmonic arterial trunk separation. Ratio of MPAD TO AAD was calculated by division of the values of MPAD and AAD in manual mode. Result: In this retrospective consideration, population was divided into groups of mild (43 patients with 42.6% males), moderate (30 patients with 36% males), and severe (17 patients with 21.3% males) pneumonia patients. Diameter of MPA in mild COVID pneumonia group had 23.8±3.4, moderate group had 26.7±4.3, and severe group had 29.9±3.6 (p&lt;0.001). Diameter of AA in mild group had 28.1±3.7, moderate group had 31.0±4.2, and severe group had 34.0±4.2 (p &lt; 0.001). Diameter of LPA in mild group had 16.1±2.0, moderate group had 17.5±2.1, and severe group had 19.1±2.0 (p &lt; 0.001). Conclusion: Pneumonia severity of COVID-19 patients in severe group showed greater MPAD as compared to moderate group and then mild group patients, respectively. A chest computed tomography (CT) scan/high-resolution CT can be useful to determine the pneumonia extension evaluation, by measuring the MPAD which can provide extraprognostic information and aid doctors inpatient treatment

Cooling towers influence in an urban environment: A predictive model to control and prevent Legionella risk and Legionellosis events

Cooling towers (CTs) are used to dissipate excess heat from water by evaporation, common in large facilities as hospital, companies, and hotels. The main risk attributed to CTs is represented by Legionella, a Gram-negative bacterium associated with a severe form of pneumonia known as Legionnaires' disease (LD). The infection route is by inhalation of aerosols reaching the lower respiratory tract. Despite several events associated with CTs, the knowledge in this field is still limited. The aim of this study was to develop a predictive model of bioaerosol dispersion using PM10 particles as a proxy, to generate risk maps of Legionella spread in the surrounding area in several weather and microbiological conditions. The Legionella contamination in the CT basin was 40938 ± 24523 cfu/L, with four peaks independent of the season, associated with an increase in air minimum temperature values (+1–2 °C) and a high relative humidity (66–100%) preceded by rainfall (0.2–30.6 mm/day). The model revealed that the most extensive bioaerosol spread is predicted in winter and summer, with an increase in Legionella risk at a distance of up to 1.5 km from the CT. This method represents a novel integrated approach for the prevention and management of LD risk in CTs

Cornelia de Lange syndrome with NIBPL mutation and mosaic Turner syndrome in the same individual

Background: Cornelia de Lange syndrome (CdLS) is a dominantly inherited disorder characterized by facial dysmorphism, growth and cognitive impairment, limb malformations and multiple organ involvement. Mutations in NIPBL gene account for about 60% of patients with CdLS. This gene encodes a key regulator of the Cohesin complex, which controls sister chromatid segregation during both mitosis and meiosis. Turner syndrome (TS) results from the partial or complete absence of one of the X chromosomes, usually associated with congenital lymphedema, short stature, and gonadal dysgenesis. Case presentation: Here we report a four-year-old female with CdLS due to a frameshift mutation in the NIPBL gene (c.1445_1448delGAGA), who also had a tissue-specific mosaic 45,X/46,XX karyotype. The patient showed a severe form of CdLS with craniofacial dysmorphism, pre- and post-natal growth delay, cardiovascular abnormalities, hirsutism and severe psychomotor retardation with behavioural problems. She also presented with minor clinical features consistent with TS, including peripheral lymphedema and webbed neck. The NIPBL mutation was present in the two tissues analysed from different embryonic origins (peripheral blood lymphocytes and oral mucosa epithelial cells). However, the percentage of cells with monosomy X was low and variable in tissues. These findings indicate that, ontogenically, the NIPBL mutation may have appeared before the mosaic monosomy X. Conclusions: The coexistence in several patients of these two rare disorders raises the issue of whether there is indeed a cause-effect association. The detailed clinical descriptions indicate predominant CdLS phenotype, although additional TS manifestations may appear in adolescence

Detection of COVID-19 Using Heart Rate and Blood Pressure: Lessons Learned from Patients with ARDS

The world has been affected by COVID-19 coronavirus. At the time of this study, the number of infected people in the United States is the highest globally (7.9 million infections). Within the infected population, patients diagnosed with acute respiratory distress syndrome (ARDS) are in more life-threatening circumstances, resulting in severe respiratory system failure. Various studies have investigated the infections to COVID-19 and ARDS by monitoring laboratory metrics and symptoms. Unfortunately, these methods are merely limited to clinical settings, and symptom-based methods are shown to be ineffective. In contrast, vital signs (e.g., heart rate) have been utilized to early-detect different respiratory diseases in ubiquitous health monitoring. We posit that such biomarkers are informative in identifying ARDS patients infected with COVID-19. In this study, we investigate the behavior of COVID-19 on ARDS patients by utilizing simple vital signs. We analyze the long-term daily logs of blood pressure and heart rate associated with 70 ARDS patients admitted to five University of California academic health centers (containing 42506 samples for each vital sign) to distinguish subjects with COVID-19 positive and negative test results. In addition to the statistical analysis, we develop a deep neural network model to extract features from the longitudinal data. Using only the first eight days of the data, our deep learning model is able to achieve 78.79% accuracy to classify the vital signs of ARDS patients infected with COVID-19 versus other ARDS diagnosed patients

A simplified estimate of the Effective Reproduction Number RtR_t using its relation with the doubling time and application to Italian COVID-19 data

A simplified method to compute $R_t$, the Effective Reproduction Number, is presented. The method relates the value of $R_t$ to the estimation of the doubling time performed with a local exponential fit. The condition $R_t = 1$ corresponds to a growth rate equal to zero or equivalently an infinite doubling time. Different assumptions on the probability distribution of the generation time are considered. A simple analytical solution is presented in case the generation time follows a gamma distribution.Comment: Submitted to: The European Physical Journal Plus. Revised version according to reviewer's comment