Impact of different dosing regimens of clopidogrel on systemic oxidative stress in patients undergoing elective percutaneous coronary intervention.

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The SEE-GeoForm WebGIS: a tool for seismic data and hazard analysis

The SEE-GeoForm project (Site Effects Evaluation - Geological Form) is born to share and make easily accessible via Internet seismic hazard data for Italy at different scales and for different administrative units (regions, provinces, municipalities), from existing database or new dataset carried out in this project. Using a WebGIS (http://www.seegeoform.it) a tool to archive, display and elaborate information has been developed. In particular, the website allows the user to query the basic and local seismic hazard values for single municipalities or to calculate those for any single point only by clicking on the maps. In order to make the WebGIS more flexible, the system has been fully implemented using open source technologies, based on the guidelines expressed by the Open Geospatial Consortium (OGC); in this way, it has been possible to develop some thematic modules for data elaborations and queries as integrated web services such as WMS, following all of the internationally-acknowledged best-practices in this field. The WebGIS has three frames: the data panel, the display area, the map layers directories. The data panel has several modules concerning respectively: basic and local hazard data for all Italian municipalities calculated by National Institute of Geophisics and Volcanology (INGV) or from other studies, such as horizontal peak ground acceleration values for different return periods (considering the exceedance probability in 50 years), and soil classes with the corresponding lithostratigraphic amplification factors according to the EuroCode8; a regular grid of 16.810 points, with a step equal to 0.05°, used by INGV for the seismic hazard elaborations (http://zonesismiche.mi.ingv.it/): values that are necessary to draw the site-dependent response spectra, according to the Italian seismic code, are linked to each point; the calculation on user demand of basic seismic hazard parameters for a site selected by clicking on geographical layers; composite seismogenic sources from DISS (Database of Individual Seismogenic Sources, vers. 3.1.1.: http://diss.rm.ingv.it/diss/), with their relative parameters (maximum moment magnitude, strike, dip, etc.). Finally, there are two modules regarding litoseismic classes and subsoil categories: the first one is linked to a map obtained by reclassifying the 46 litothypes of the Lithological Map of Italy at 100000-scale by Geological Survey of Italy (National Institute for Environmental Protection and Research - ISPRA) into 12 litoseismic classes, considered homogeneous regarding to their seismic behavior; while the second one permits to know the subsoil category, according with Italian seismic provisions (Norme Tecniche per le Costruzioni – NTC 2008), for a single point by clicking on the map. This has been possible by elaborating a subsoil categories map at 100000-scale derived from the litoseismic map at the same scale, by blending different litoseismic classes into 5 categories. Datasets have been built starting from 2007 within the ReLUIS Project (http://www.reluis.it) and are being improved within the 2009-2012 EUCENTRE project (http://www.eucentre.it), that partially financed the WebGIS development, as a result of the strong collaboration between researchers from INGV and ISPRA. The SEE-GeoForm web-tool aims to become the focal point to display in a simple way many databases containing information on seismic hazard of Italian territory, allowing user-friendly elaborations for researchers and professionals

Il Progetto SEE-GeoForm: uno strumento per la consultazione di dati geologici e di pericolosità sismica riferiti all’intero territorio nazionale

Il progetto SEE-GeoForm (Site Effects Evaluation - Geological Form: http://www.seegeoform.it) nasce con l’obiettivo di realizzare uno strumento semplice, potente e completo per la consultazione e la rappresentazione, tramite un WebGIS, di dati geologici, geomorfologici, geotecnici e geofisici relativi all’intero territorio italiano. In questo modo, si vogliono concentrare in un sistema flessibile e intuitivo, dotato di un’unica modalità di accesso e consultazione, una serie di informazioni che attualmente sono disperse in numerosi database mono-tematici consultabili via Internet. Attualmente il WebGIS contiene dati georeferenziati e carte tematiche relative alla pericolosità sismica a differenti scale territoriali e per diverse unità amministrative (regioni, province e comuni). Le informazioni provengono sia da banche dati esistenti che da elaborazioni effettuate “ad hoc” nell’ambito di questo progetto (carte tematiche in scala 1:100.000 del territorio italiano). Per rendere il sistema più flessibile ed aggiornabile è stata sviluppata una piattaforma che utilizza esclusivamente tecnologie “open source”, basate sulle linee guida dell’Open Geospatial Consortium (OGC); in questo modo è stato possibile realizzare alcuni moduli tematici che sono totalmente compatibili con il protocollo standard denominato WMS (Web Map Services) per la consultazione e la visualizzazione spaziale dei dati tramite Internet

Effect of Interleukin-1 Blockade With Anakinra on Leukocyte Count in Patients With ST-Segment Elevation Acute Myocardial Infarction

Leukocytosis is a common finding in patients with ST elevation myocardial infarction (STEMI) and portends a poor prognosis. Interleukin 1-β regulates leukopoiesis and pre-clinical studies suggest that anakinra (recombinant human interleukin-1 [IL-1] receptor antagonist) suppresses leukocytosis in myocardial infarction. However, the effect of IL-1 blockade with anakinra on leukocyte count in patients with STEMI is unknown. We reviewed the white blood cell (WBC) and differential count of 99 patients enrolled in a clinical trial of anakinra (n = 64) versus placebo (n = 35) for 14 days after STEMI. A complete blood cell count with differential count were obtained at admission, and after 72 h, 14 days and 3 months. After 72 h from treatment, anakinra compared to placebo led to a statistically significant greater percent reduction in total WBC count (− 35% [− 48 to − 24] vs. − 21% [− 34 to − 10], P = 0.008), absolute neutrophil count (− 48% [− 60 to − 22] vs. − 27% [− 46 to − 5], P = 0.004) and to an increase in absolute eosinophil count (+ 50% [0 to + 100] vs. 0% [− 50 to + 62], P = 0.022). These changes persisted while on treatment at 14 days and were no longer apparent at 3 months after treatment discontinuation. We found that in patients with STEMI IL-1 blockade with anakinra accelerates resolution of leukocytosis and neutrophilia. This modulation may represent one of the mechanisms by which IL-1 blockade improves clinical outcomes

I.S.Mu.L.T - Rotator cuff tears guidelines

Despite the high level achieved in the field of shoulder surgery, a global consensus on rotator cuff tears management is lacking. This work is divided into two main sessions: in the first, we set questions about hot topics involved in the rotator cuff tears, from the etiopathogenesis to the surgical treatment. In the second, we answered these questions by mentioning Evidence Based Medicine. The aim of the present work is to provide easily accessible guidelines: they could be considered as recommendations for a good clinical practice developed through a process of systematic review of the literature and expert opinion, in order to improve the quality of care and rationalize the use of resources

Interleukin‐1 Blockade Inhibits the Acute Inflammatory Response in Patients With ST‐Segment–Elevation Myocardial Infarction

Background ST‐segment–elevation myocardial infarction is associated with an intense acute inflammatory response and risk of heart failure. We tested whether interleukin‐1 blockade with anakinra significantly reduced the area under the curve for hsCRP (high sensitivity C‐reactive protein) levels during the first 14 days in patients with ST‐segment–elevation myocardial infarction (VCUART3 [Virginia Commonwealth University Anakinra Remodeling Trial 3]). Methods and Results We conducted a randomized, placebo‐controlled, double‐blind, clinical trial in 99 patients with ST‐segment–elevation myocardial infarction in which patients were assigned to 2 weeks treatment with anakinra once daily (N=33), anakinra twice daily (N=31), or placebo (N=35). hsCRP area under the curve was significantly lower in patients receiving anakinra versus placebo (median, 67 [interquartile range, 39–120] versus 214 [interquartile range, 131–394] mg·day/L; P\u3c0.001), without significant differences between the anakinra arms. No significant differences were found between anakinra and placebo groups in the interval changes in left ventricular end‐systolic volume (median, 1.4 [interquartile range, −9.8 to 9.8] versus −3.9 [interquartile range, −15.4 to 1.4] mL; P=0.21) or left ventricular ejection fraction (median, 3.9% [interquartile range, −1.6% to 10.2%] versus 2.7% [interquartile range, −1.8% to 9.3%]; P=0.61) at 12 months. The incidence of death or new‐onset heart failure or of death and hospitalization for heart failure was significantly lower with anakinra versus placebo (9.4% versus 25.7% [P=0.046] and 0% versus 11.4% [P=0.011], respectively), without difference between the anakinra arms. The incidence of serious infection was not different between anakinra and placebo groups (14% versus 14%; P=0.98). Injection site reactions occurred more frequently in patients receiving anakinra (22%) versus placebo (3%; P=0.016). Conclusions In patients presenting with ST‐segment–elevation myocardial infarction, interleukin‐1 blockade with anakinra significantly reduces the systemic inflammatory response compared with placebo. Clinical Trial Registration URL: https://www.clinicaltrials.gov/. Unique identifier: NCT01950299

Insight in cognitive impairment assessed with the Cognitive Assessment Interview in a large sample of patients with schizophrenia

The Cognitive Assessment Interview (CAI) is an interview-based scale measuring cognitive impairment and its impact on functioning in subjects with schizophrenia (SCZ). The present study aimed at assessing, in a large sample of SCZ (n = 601), the agreement between patients and their informants on CAI ratings, to explore patients' insight in their cognitive deficits and its relationships with clinical and functional indices. Agreement between patient- and informant-based ratings was assessed by the Gwet's agreement coefficient. Predictors of insight in cognitive deficits were explored by stepwise multiple regression analyses. Patients reported lower severity of cognitive impairment vs. informants. A substantial to almost perfect agreement was observed between patients' and informants' ratings. Lower insight in cognitive deficits was associated to greater severity of neurocognitive impairment and positive symptoms, lower severity of depressive symptoms, and older age. Worse real-life functioning was associated to lower insight in cognitive deficit, worse neurocognitive performance, and worse functional capacity. Our findings indicate that the CAI is a valid co-primary measure with the interview to patients providing a reliable assessment of their cognitive deficits. In the absence of informants with good knowledge of the subject, the interview to the patient may represent a valid alternative

Notulae to the Italian alien vascular flora: 11

In this contribution, new data concerning the distribution of vascular flora alien to Italy are presented. It includes new records, confirmations, exclusions, and status changes for Italy or for Italian administrative regions. Nomenclatural and distribution updates published elsewhere are provided as Suppl. material 1

Clinical Features, Cardiovascular Risk Profile, and Therapeutic Trajectories of Patients with Type 2 Diabetes Candidate for Oral Semaglutide Therapy in the Italian Specialist Care

Introduction: This study aimed to address therapeutic inertia in the management of type 2 diabetes (T2D) by investigating the potential of early treatment with oral semaglutide. Methods: A cross-sectional survey was conducted between October 2021 and April 2022 among specialists treating individuals with T2D. A scientific committee designed a data collection form covering demographics, cardiovascular risk, glucose control metrics, ongoing therapies, and physician judgments on treatment appropriateness. Participants completed anonymous patient questionnaires reflecting routine clinical encounters. The preferred therapeutic regimen for each patient was also identified. Results: The analysis was conducted on 4449 patients initiating oral semaglutide. The population had a relatively short disease duration (42%  60% of patients, and more often than sitagliptin or empagliflozin. Conclusion: The study supports the potential of early implementation of oral semaglutide as a strategy to overcome therapeutic inertia and enhance T2D management