Safety ranking definition for infrastructures with high PTW flow

Powered two-wheelers (PTWs) provide a suitable mode for a large portion of population in many cities due to rider's personal convenience and the vehicle supposed easiness of manoeuvring. At the same time PTWs present serious safety issues compared to other motorized vehicles. This paper reports the main outcome of study carried out in Rome, where this mode is very popular and assesses the economic efforts to make infrastructure safer for PTWs. The methodology, extensively described in the paper, includes three steps: the accident analysis, the development of economic indicators of accidents costs, the maintenance priority. In the first step the location of the PTWs local accidents are identified, then the accidents are analyzed by means of the suitable indicators and, among these the safety potential (SAPO). Lastly, according to the results of the analyzed indicators the need of infrastructure maintenance will be defined. Usually SAPO is applied to rural areas, but here it has been adapted to describe the phenomena of the urban area in hand. As a result, the estimation of the saving potential to improve the infrastructure safety levels, thus reducing the amount of accidents, is presented, along with recommendations on how to upscale the SAPO at city level

Non-invasive methods to assess biomarkers of exposure and early stage of pulmonary disease in smoking subjects

Cigarette smoking is the major factor implicated in the pathogenesis of chronic obstructive pulmonary disease (COPD), despite the fact that only susceptible smoking subjects develop this respiratory disease. In the last few years non–invasive techniques such as induced sputum (IS), exhaled nitric oxide (eNO) measurement and exhaled breath condensate (EBC) collection have been successfully established revealing an inflammatory status and oxidative stress indicators in the airways involved in the pathogenesis of several pulmonary diseases. Using these new non-invasive experimental tools recently, several efforts have been made to find new biomarkers in order to assess and monitor early lung damage induced by smoking. Tobacco smoke can acutely reduce eNO levels in healthy smokers and non-smoker subjects so it can play a role in anti-smoking programmes; its increase can be a positive parameter for subjects who are going to stop cigarette smoking and at the same time be used as an anti-smoking indicator. It can be useful to investigate the mechanism of cigarette-induced lung damage in an experimental setting and may potentially be useful for assessing of Environmental Tobacco Smoke (ETS) effects. Markers of oxidative stress have been detected in induced sputum of COPD subjects even though only few studies investigated the use of induced sputum to study smoke effects on the lungs of healthy subjects. Exhaled breath condensate (EBC) obtained by cooling exhaled air under conditions of spontaneous breathing is a promising biological fluid that could provide a real-time assessment of pulmonary pathobiology. The analysis of induced sputum and of exhaled air is feasible and non-invasive, can be useful to identify new biomarkers of exposure or susceptibility in COPD patients to enhance the understanding of airways changes due to current smoking and may be useful to find new biomarkers in order to assess and monitor early lung damage induced by smoke in order to prevent the progression of obstructive disease

Cancer patients and telenursing interventions in Italy. a systematic review

Objective: The use of digital technologies could improve patients’ quality of care, satisfaction, and health-related outcomes in cancer patients. This paper aims to explore the use of digital technologies in nursing management of cancer patients in Italy. Patients and Methods: A systematic literature review was performed. PubMed, Excerpta Medica dataBASE (Embase), Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Cochrane Library databases were consulted from September 1, 2021, to January 31, 2022. Key terms for Telenurs-ing/Telemedicine and cancer in Italy were used. The quality of each study was assessed through the Grading of Recommendations, Assessment, Development, and Evaluations method. Results: 131 articles were found and 5 were included: two randomized-clinical-trial protocols aimed to explore the impact of medication management apps on patients’ quality of life; one validation trial suggested good reliability in the therapeutic adherence of patients on chemotherapy but limited sensitivity in detecting related adverse events; two observational studies described the validation of telephone triage prehospitalization programs performed by nurses during the pandemic. Conclusions: The use of digital technologies in nursing management of cancer patients is in-frequent in Italy, however, increased during the pandemic. Further studies are needed to evaluate the impact and effectiveness of the use of digital technologies in nursing management in cancer patients

Cancer patients and telenursing interventions in Italy: a systematic review

OBJECTIVE: The use of digital technologies could improve patients’ quality of care, satisfaction, and health-related outcomes in cancer patients. This paper aims to explore the use of digital technologies in nursing management of cancer patients in Italy. PATIENTS AND METHODS: A systematic literature review was performed. PubMed, Excerpta Medica dataBASE (Embase), Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Cochrane Library databases were consulted from September 1, 2021, to January 31, 2022. Key terms for Telenursing/Telemedicine and cancer in Italy were used. The quality of each study was assessed through the Grading of Recommendations, Assessment, Development, and Evaluations method. RESULTS: 131 articles were found and 5 were included: two randomized-clinical-trial protocols aimed to explore the impact of medication management apps on patients' quality of life; one validation trial suggested good reliability in the therapeutic adherence of patients on chemotherapy but limited sensitivity in detecting related adverse events; two observational studies described the validation of telephone triage prehospitalization programs performed by nurses during the pandemic. CONCLUSIONS: The use of digital technologies in nursing management of cancer patients is infrequent, however, increased during the pandemic. Further studies are needed to evaluate the impact and effectiveness of the use of digital technologies in nursing management in cancer patients

Diagnostic and prognostic impact of serum HE4 detection in endometrial carcinoma patients

Background:To date, no good marker for screening or disease monitoring of endometrial cancer (EC) is available. The aims of this study were to investigate HE4 gene, protein expression and serum HE4 (sHE4) levels in a panel of ECs and normal endometria (NEs) and to correlate sHE4 with patient clinicopathological characteristics and prognosis.Methods:Using quantitative real-time PCR we tested 46 ECs and 20 NEs for HE4 gene expression. Protein expression was analysed by immunohistochemistry on tissue microarrays in 153 ECs and 33 NEs. Pre-operative serum samples from 138 EC and 76 NE patients were analysed with HE4-EIA assay. Association between sHE4 and patient clinicopathological characteristics or outcome was evaluated.Results:Protein and HE4 gene were significantly upregulated in EC tissues and sera, compared with controls. High sHE4 levels were significantly associated with worse EC clinical characteristics. By univariate survival analysis, high sHE4 levels significantly correlated with decreased overall survival, progression-free survival and disease-free survival, retaining their independent prognostic value on the poorly differentiated EC cohort.Conclusion:We demonstrate, for the first time, that high sHE4 levels correlates with an aggressive EC phenotype and may constitute an independent prognostic factor for poorly differentiated-ECs. Determination of sHE4 could be clinically useful in identifying high-risk EC patients for a more aggressive adjuvant therapy.British Journal of Cancer advance online publication, 5 April 2011; doi:10.1038/bjc.2011.109 www.bjcancer.com

Ambroxol in the 21st century: pharmacological and clinical update

Background: Belonging to the group of expectorants, ambroxol is an active substance with a long history that influences parameters considered to be the basis for the physiological production and the transport of the bronchial mucus. Therefore, ambroxol's indication is 'secretolytic therapy in acute and chronic bronchopulmonary diseases associated with abnormal mucus secretion and impaired mucus transport'. Objective: The aim of this review is to evaluate the pharmacological and clinical data on the mucokinetic compound ambroxol. Methods: The existing database that covers > 40 years of pharmacological research and clinical development was analysed. only studies with adequate study design were evaluated. Conclusion: Ambroxol is shown to exert several activities: i) secretolytic activity (i.e., promotes mucus clearance, facilitates expectoration, and eases productive cough); ii) anti-inflammatory and antioxidant activity; and iii) a local anaesthetic effect through sodium channel blocking at the level of the cell membrane. The reduction on chronic obstructive pulmonary disease exacerbations is consistent and clinically relevant. The anaesthetic effect is a new pharmacological action that could be beneficial in the management of acute respiratory tract infections. The efficacy and safety of ambroxol is well established

Non-invasive methods to assess biomarkers of exposure and early stage of pulmonary disease in smoking subjects.

Cigarette smoking is the major factor implicated in the pathogenesis of chronic obstructive pulmonary disease (COPD), despite the fact that only susceptible smoking subjects develop this respiratory disease. In the last few years non-invasive techniques such as induced sputum (IS), exhaled nitric oxide (eNO) measurement and exhaled breath condensate (EBC) collection have been successfully established revealing an inflammatory status and oxidative stress indicators in the airways involved in the pathogenesis of several pulmonary diseases. Using these new non-invasive experimental tools recently, several efforts have been made to find new biomarkers in order to assess and monitor early lung damage induced by smoking. Tobacco smoke can acutely reduce eNO levels in healthy smokers and non-smoker subjects so it can play a role in anti-smoking programmes; its increase can be a positive parameter for subjects who are going to stop cigarette smoking and at the same time be used as an anti-smoking indicator. It can be useful to investigate the mechanism of cigarette-induced lung damage in an experimental setting and may potentially be useful for assessing of Environmental Tobacco Smoke (ETS) effects. Markers of oxidative stress have been detected in induced sputum of COPD subjects even though only few studies investigated the use of induced sputum to study smoke effects on the lungs of healthy subjects. Exhaled breath condensate (EBC) obtained by cooling exhaled air under conditions of spontaneous breathing is a promising biological fluid that could provide a real-time assessment of pulmonary pathobiology. The analysis of induced sputum and of exhaled air is feasible and non-invasive, can be useful to identify new biomarkers of exposure or susceptibility in COPD patients to enhance the understanding of airways changes due to current smoking and may be useful to find new biomarkers in order to assess and monitor early lung damage induced by smoke in order to prevent the progression of obstructive disease

Non-invasive methods to assess biomarkers of exposure and early stage of pulmonary disease in smoking subjects.

Cigarette smoking is the major factor implicated in the pathogenesis of chronic obstructive pulmonary disease (COPD), despite the fact that only susceptible smoking subjects develop this respiratory disease. In the last few years non-invasive techniques such as induced sputum (IS), exhaled nitric oxide (eNO) measurement and exhaled breath condensate (EBC) collection have been successfully established revealing an inflammatory status and oxidative stress indicators in the airways involved in the pathogenesis of several pulmonary diseases. Using these new non-invasive experimental tools recently, several efforts have been made to find new biomarkers in order to assess and monitor early lung damage induced by smoking. Tobacco smoke can acutely reduce eNO levels in healthy smokers and non-smoker subjects so it can play a role in anti-smoking programmes; its increase can be a positive parameter for subjects who are going to stop cigarette smoking and at the same time be used as an anti-smoking indicator. It can be useful to investigate the mechanism of cigarette-induced lung damage in an experimental setting and may potentially be useful for assessing of Environmental Tobacco Smoke (ETS) effects. Markers of oxidative stress have been detected in induced sputum of COPD subjects even though only few studies investigated the use of induced sputum to study smoke effects on the lungs of healthy subjects. Exhaled breath condensate (EBC) obtained by cooling exhaled air under conditions of spontaneous breathing is a promising biological fluid that could provide a real-time assessment of pulmonary pathobiology. The analysis of induced sputum and of exhaled air is feasible and non-invasive, can be useful to identify new biomarkers of exposure or susceptibility in COPD patients to enhance the understanding of airways changes due to current smoking and may be useful to find new biomarkers in order to assess and monitor early lung damage induced by smoke in order to prevent the progression of obstructive disease

UPPER EXTREMITY DEEP VEIN THROMBOSIS AS AN UNCOMMON COMPLICATION OF PACEMAKER IMPLANTATION: A CASE REPORT

Venous complications of pacemaker implantation rarely cause immediate clinical problems. An 89-year-old man, without thrombophilia, 4 weeks after a pacemaker implantation experienced functional impotence of the left arm that appeared warm, reddened, oedematous and painful. Color Doppler Ultrasonography revealed a thrombosis of the axillary vein extended to the proximal third of the ulnar vein. In our opinion, upper extremity deep vein thrombosis (UEDVT) represents an important complication of post-surgical pacemaker implantation that should be suspected early, even without specific symptoms and thrombophilia