Idiopathic calcium nephrolithiasis with pure calcium oxalate composition: clinical correlates of the calcium oxalate dihydrate/monohydrate (COD/COM) stone ratio

Pure calcium oxalate is the most frequent type of idiopathic kidney stone composition. Fourier transform infrared spectroscopy (FT-IR) allows to detect the ratio of calcium oxalate dihydrate (COD) and monohydrate (COM) crystals in stones, but the clinical significance of this parameter remains uncertain. The objective of this observational study was to verify the association of clinical and laboratory parameters of kidney stone disease with COD/COM ratio in a group of 465 (322 M, age 46 ± 14) patients suffering from idiopathic calcium nephrolithiasis with pure calcium oxalate stones (≥ 97%). Each participant underwent a complete clinical examination, serum chemistry, 24-h urine collection for the determination of the profile of lithogenic risk, and had stones analyzed by FT-IR. Most (62%) of the stones had a COD/COM ratio ≤ 0.25, and the urine chemistry of the corresponding patients showed a low prevalence of urinary metabolic abnormalities. With increasing COD/COM ratio intervals (0–0.25, 0.26–0.50, 0.51–0.75, 0.76–1), a significant association was observed for the number of urological procedures, serum calcium, 24-h urinary calcium excretion, prevalence of hypercalciuria and relative calcium oxalate supersaturation, and a negative trend was detected for the age of the first stone episode (all p values < 0.05). A linear regression model showed that the only parameters significantly associated with COD/COM ratio were 24-h urinary calcium excretion (standardized β = 0.464, p < 0.001) and urine pH (standardized β = 0.103, p = 0.013). In pure calcium oxalate idiopathic stones, COD/COM ratio may reflect the presence of urinary metabolic risk factors, and represent a guide for the prescription of urinary analyses

Neonatal effects of the administration of meperidine and promethazine to the mother in labor. Double blind study

Peer Reviewe

The Interplay between Magnesium and Testosterone in Modulating Physical Function in Men

The role of nutritional status as determinant of successful aging is very well recognized. There is recent evidence that nutrition may exert its beneficial effects through the modulation of the hormonal anabolic milieu. Under-nutrition and anabolic hormonal deficiency frequently coexist in older individuals determining an increased risk of mobility impairment and adverse outcomes. Mineral dietary assessment has received attention as key component of the nutritional modulation of anabolic status and physical performance. There is evidence that several minerals, including magnesium, exert a positive influence on Insulin-like Growth Factor-1 (IGF-1) secretion in both sexes, and Testosterone (T) in men. In this review we summarize the existing knowledge about the mechanisms by which magnesium can affect T bioactivity in older men. Particular attention will be also devoted to the preliminary observational and intervention studies addressing the relationship between magnesium and T in adult and older individuals. We believe that, if larger studies will confirm these pivotal data, hormonal and mineral strategies might be adopted as synergistic treatment to approach the multifactorial nature of accelerated aging

La stratégie de A à Z, 350 mots pour comprendre

L\u27ouvrage présente et illustre les 350 notions les plus représentatives du champ de la stratégie dans un style à la fois accessible et rigoureux. Il traite des différentes facettes de la stratégie : diagnostic, management stratégique, manoeuvres concurrentielles, innovation, changement, pilotage stratégique.. Chaque entrée propose la traduction anglaise du terme proposé, une présentation simple du concept et une illustration concrète. Une attention particulière est portée aux renvois entre les entrées et à leur complémentarité, afin de veiller à donner de la cohérence à l\u27ouvrage. L\u27équipe de quatre auteurs dispose de compétences et de champ d\u27intérêt très complémentaires

Delirium in COVID-19: epidemiology and clinical correlations in a large group of patients admitted to an academic hospital

Background: Delirium incidence and clinical correlates in coronavirus disease-19 (COVID-19) pneumonia are still poorly investigated. Aim: To describe the epidemiology of delirium in patients hospitalized for suspect COVID-19 pneumonia during the pandemic peak in an academic hospital of Northern Italy, identify its clinical correlations and evaluate the association with mortality. Methods: The clinical records of 852 patients admitted for suspect COVID-19 pneumonia, defined as respiratory symptoms or fever or certain history of contact with COVID-19 patients, plus chest CT imaging compatible with alveolar-interstitial pneumonia, were retrospectively analyzed. Delirium was defined after careful revision of daily clinical reports in accordance with the Confusion Assessment Method criteria. Data on age, clinical presentation, comorbidities, drugs, baseline lab tests and outcome were collected. The factors associated with delirium, and the association of delirium with mortality, were evaluated through binary logistic regression models. Results: Ninety-four patients (11%) developed delirium during stay. They were older (median age 82, interquartile range, IQR 78–89, vs 75, IQR 63–84, p < 0.001), had more neuropsychiatric comorbidities and worse respiratory exchanges at baseline. At multivariate models, delirium was independently and positively associated with age [odds ratio (OR) 1.093, 95% confidence interval (CI) 1.046–1.143, p < 0.001], use of antipsychotic drugs (OR 4.529, 95% CI 1.204–17.027, p = 0.025), serum urea and lactate-dehydrogenase at admission. Despite a higher mortality in patients with delirium (57% vs 30%), this association was not independent of age and respiratory parameters. Conclusions: Delirium represents a common complication of COVID-19 and a marker of severe disease course, especially in older patients with neuropsychiatric comorbidity

Clinical features, histopathology and differential diagnosis of sarcoidosis

Sarcoidosis is a chameleon disease of unknown etiology, characterized by the growth of non-necrotizing and non-caseating granulomas and manifesting with clinical pictures that vary on the basis of the organs that are mainly affected. Lungs and intrathoracic lymph nodes are the sites that are most often involved, but virtually no organ is spared from this disease. Histopathology is distinctive but not pathognomonic, since the findings can be found also in other granulomatous disorders. The knowledge of these findings is important because it could be helpful to differentiate sarcoidosis from the other granulomatous-related diseases. This review aims at illustrating the main clinical and histopathological findings that could help clinicians in their routine clinical practice

Using XDAQ in Application Scenarios of the CMS Experiment

XDAQ is a generic data acquisition software environment that emerged from a rich set of of use-cases encountered in the CMS experiment. They cover not the deployment for multiple sub-detectors and the operation of different processing and networking equipment as well as a distributed collaboration of users with different needs. The use of the software in various application scenarios demonstrated the viability of the approach. We discuss two applications, the tracker local DAQ system for front-end commissioning and the muon chamber validation system. The description is completed by a brief overview of XDAQ.Comment: Conference CHEP 2003 (Computing in High Energy and Nuclear Physics, La Jolla, CA

Is lung ultrasound score a useful tool to monitoring and handling moderate and severe COVID-19 patients in the general ward? An observational pilot study

Lung ultrasound is a well-established diagnostic tool in acute respiratory failure, and it has been shown to be particularly suited for the management of COVID-19-associated respiratory failure. We present exploratory analyses on the diagnostic and prognostic performance of lung ultrasound score (LUS) in general ward patients with moderate-to-severe COVID-19 pneumonia receiving O2 supplementation and/or noninvasive ventilation. From March 10 through May 1, 2020, 103 lung ultrasound exams were performed by our Forward Intensive Care Team (FICT) on 26 patients (18 males and 8 females), aged 62 (54 – 76) and with a Body Mass Index (BMI) of 30.9 (28.7 – 31.5), a median 6 (5 – 9) days after admission to the COVID-19 medical unit of the University Hospital of Parma, Italy. All patients underwent chest computed tomography (CT) the day of admission. The initial LUS was 16 (11 – 21), which did not significantly correlate with initial CT scans, probably due to rapid progression of the disease and time between CT scan on admission and first FICT evaluation; conversely, LUS was significantly correlated with PaO2/FiO2 ratio throughout patient follow-up [R = − 4.82 (− 6.84 to − 2.80; p < 0.001)]. The area under the receiving operating characteristics curve of LUS for the diagnosis of moderate-severe disease (PaO2/FiO2 ratio ≤ 200 mmHg) was 0.73, with an optimal cutoff value of 11 (positive predictive value: 0.98; negative predictive value: 0.29). Patients who eventually needed invasive ventilation and/or died during admission had significantly higher LUS throughout their stay

Commissioning of the CMS High Level Trigger

The CMS experiment will collect data from the proton-proton collisions delivered by the Large Hadron Collider (LHC) at a centre-of-mass energy up to 14 TeV. The CMS trigger system is designed to cope with unprecedented luminosities and LHC bunch-crossing rates up to 40 MHz. The unique CMS trigger architecture only employs two trigger levels. The Level-1 trigger is implemented using custom electronics, while the High Level Trigger (HLT) is based on software algorithms running on a large cluster of commercial processors, the Event Filter Farm. We present the major functionalities of the CMS High Level Trigger system as of the starting of LHC beams operations in September 2008. The validation of the HLT system in the online environment with Monte Carlo simulated data and its commissioning during cosmic rays data taking campaigns are discussed in detail. We conclude with the description of the HLT operations with the first circulating LHC beams before the incident occurred the 19th September 2008