45 research outputs found

    The incidence of hip, forearm, humeral, ankle, and vertebral fragility fractures in Italy: results from a 3-year multicenter study

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    INTRODUCTION: We aimed to assess the incidence and hospitalization rate of hip and "minor" fragility fractures in the Italian population. METHODS: We carried out a 3-year survey at 10 major Italian emergency departments to evaluate the hospitalization rate of hip, forearm, humeral, ankle, and vertebral fragility fractures in people 45 years or older between 2004 and 2006, both men and women. These data were compared with those recorded in the national hospitalizations database (SDO) to assess the overall incidence of fragility fractures occurring at hip and other sites, including also those events not resulting in hospital admissions. RESULTS: We observed 29,017 fractures across 3 years, with hospitalization rates of 93.0% for hip fractures, 36.3% for humeral fractures, 31.3% for ankle fractures, 22.6% for forearm/wrist fractures, and 27.6% for clinical vertebral fractures. According to the analyses performed with the Italian hospitalization database in year 2006, we estimated an annual incidence of 87,000 hip, 48,000 humeral, 36,000 ankle, 85,000 wrist, and 155,000 vertebral fragility fractures in people aged 45 years or older (thus resulting in almost 410,000 new fractures per year). Clinical vertebral fractures were recorded in 47,000 events per year. CONCLUSIONS: The burden of fragility fractures in the Italian population is very high and calls for effective preventive strategies

    Is it really advantageous to operate proximal femoral fractures within 48 h from diagnosis? – A multicentric retrospective study exploiting COVID pandemic-related delays in time to surgery

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    Objectives: Hip fractures in the elderly are common injuries that need timely surgical management. Since the beginning of the pandemic, patients with a proximal femoral fracture (PFF) experienced a delay in time to surgery. The primary aim of this study was to evaluate a possible variation in mortality in patients with PFF when comparing COVID-19 negative versus positive. Methods: This is a multicentric and retrospective study including 3232 patients with PFF who underwent surgical management. The variables taken into account were age, gender, the time elapsed between arrival at the emergency room and intervention, pre-operative American Society of Anesthesiology score, pre-operative cardiovascular and respiratory disease, and 10-day/1-month/6-month mortality. For 2020, we had an additional column, “COVID-19 swab positivity.” Results: COVID-19 infection represents an independent mortality risk factor in patients with PFFs. Despite the delay in time-to-surgery occurring in 2020, no statistically significant variation in terms of mortality was detected. Within our sample, a statistically significant difference was not detected in terms of mortality at 6 months, in patients operated within and beyond 48 h, as well as no difference between those operated within or after 12/24/72 h. The mortality rate among subjects with PFF who tested positive for COVID-19 was statistically significantly higher than in patients with PFF who tested. COVID-19 positivity resulted in an independent factor for mortality after PFF. Conclusion: Despite the most recent literature recommending operating PFF patients as soon as possible, no significant difference in mortality was found among patients operated before or after 48 h from diagnosis

    Gli elefanti nani della Sicilia

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    WEEENmodels: la gestione sostenibile dei rifiuti elettrici ed elettronici (RAEE)

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    Il sistema europeo di raccolta dei RAEE è stato introdotto con la Direttiva 2002/96/EC che ha richiesto agli Stati membri di avviare specifiche iniziative al fine di raggiungere importanti obiettivi di raccolta. La recente Direttiva europea 2012/19/UE ha introdotto alcuni elementi di innovazione per arrivare ad obiettivi di riciclo più elevati e per definire nuovi obblighi a carico dei distributori. Particolare attenzione è stata posta sui cosiddetti “piccoli” RAEE, di lunghezza inferiore ai 50 cm., la cui raccolta è inferiore rispetto alle altre categorie di RAEE. In Italia, il D.Lgs. 49/2014 che recepisce la Direttiva europea, ha posto l’accento sulla priorità delle operazioni di riutilizzo e riuso dei RAEE e dei relativi componenti. Il progettoWeeenmodels, finanziato nell’ambito del Programma LIFE+ 2012, ha lo scopo di applicare un nuovo modello di raccolta dei RAEE domestici, ovvero un sistema che minimizzi i costi di servizio e organizzi l’offerta, secondo modalità stabili e sistematiche. L’obiettivo principale diWeeenmodels è quello di dimostrare che, attraverso l’applicazione di un efficiente sistema logistico ed un coordinamentocentralizzato dei servizi di raccolta è possibile ottenere e anche superare i target di raccolta definiti dalla direttiva europea

    Autism Spectrum Disorder: Focus on Glutamatergic Neurotransmission

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    Disturbances in the glutamatergic system have been increasingly documented in several neuropsychiatric disorders, including autism spectrum disorder (ASD). Glutamate-centered theories of ASD are based on evidence from patient samples and postmortem studies, as well as from studies documenting abnormalities in glutamatergic gene expression and metabolic pathways, including changes in the gut microbiota glutamate metabolism in patients with ASD. In addition, preclinical studies on animal models have demonstrated glutamatergic neurotransmission deficits and altered expression of glutamate synaptic proteins. At present, there are no approved glutamatergic drugs for ASD, but several ongoing clinical trials are currently focusing on evaluating in autistic patients glutamatergic pharmaceuticals already approved for other conditions. In this review, we provide an overview of the literature concerning the role of glutamatergic neurotransmission in the pathophysiology of ASD and as a potential target for novel treatments
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