Mediterranean diet adherence and synergy with acute myocardial infarction and its determinants. a multicenter case-control study in Italy.

Cardiovascular diseases are the leading causes of mortality and morbidity in Western countries. The possible synergistic effect of poor adherence to a Mediterranean diet (MD) and other risk factors for acute myocardial infarction (AMI) such as hypertension, cholesterol, ever smoker, BMI> 25, diabetes, has not been deeply studied. Design Case-control study. Methods Patients with first AMI and controls from four tertiary referral Italian centers were screened for enrolment. Dietary information was collected through a questionnaire and a MD adherence score was calculated. Physical activity and smoking habits were also registered. The Synergy Index was calculated according to Rothman. Results 127 cases and 173 controls were enrolled. The analysis was conducted using a dichotomous variable for the MD score with values 7 representing good adherence. Multivariate analysis showed the following variables associated to AMI: ever smoker (OR = 2.08), diabetes (OR = 1.42), hypertension (OR = 2.08), hypercholesterolemia (OR = 2.47), BMI> 25 (OR = 1.99), while a protective effect emerged both in subjects scoring > 7 on the MD score(OR = 0.55) and in subjects resident of Southern Italy (OR = 0.38). A synergistic effect does exist between poor adherence to the MD and the following risk factors: hypertension, hypercholesterolemia, BMI >25, diabetes and being a resident in central and northern Italy. Conclusion Synergy between heart disease risk factors and MD underlines the need to enlarge the list of known modifiable cardiovascular risk factors to include and promote adherence to Mediterranean dietary habits

L'endemisme vegetal

En el context de l'Arxipèlag Balear, la flora de Cabrera es caracteritza per presentar un nombre moderat de tàxons endèmics; únicament un d'ells és exclusiu de l'illa de Cabrera, vint són baleàrics, tres tenen una distribució baleàrico-cirno-sarda i dos es poden considerar com baleàrico-llevantins. Es realitza una anàlisi de les relacions que hi ha entre Cabrera i els seus illots i la resta de Illes Balears en funció d'aquest element endèmic.The flora of the Cabrera Archipelago is characterized by a moderate number of endemic taxa; one of them is endemic of the island of Cabrera, twenty are balearic, three have a balearic-cyrno-sardinian distribution and two can be considered as balearic-levantine endemisms. The relations between Cabrera and the other Balearic Islands concerning this endemic component are analized

Standardized Nursing Diagnoses in a Surgical Hospital Setting: A Retrospective Study Based on Electronic Health Data

Introduction: In electronic health records (EHRs), standardized nursing terminologies (SNTs), such as nursing diagnoses (NDs), are needed to demonstrate the impact of nursing care on patient outcomes. Unfortunately, the use of NDs is not common in clinical practice, especially in surgical settings, and is rarely included in EHRs. Objective(s): The aim of the study was to describe the prevalence and trend of NDs in a hospital surgical setting by also analyzing the relationship between NDs and hospital outcomes. Methods: A retrospective study was conducted. All adult inpatients consecutively admitted to one of the 15 surgical inpatient units of an Italian university hospital across 1 year were included. Data, including the Professional Assessment Instrument and the Hospital Discharge Register, were collected retrospectively from the hospital's EHRs. Results: The sample included 5,027 surgical inpatients. There was a mean of 6.3 ± 4.3 NDs per patient. The average distribution of NDs showed a stable trend throughout the year. The most representative NANDA-I ND domain was safety/protection. The total number of NDs on admission was significantly higher for patient whose length of stay was longer. A statistically significant correlation was observed between the number of NDs on admission and the number of intra-hospital patient transfers. Additionally, the mean number of NDs on admission was higher for patients who were later transferred to an intensive care unit compared to those who were not transferred. Conclusion: NDs represent the key to understanding the contribution of nurses in the surgical setting. NDs collected upon admission can represent a prognostic factor related to the hospital's key outcomes

Taking screenshots of the invisible: A study on bacterial contamination of mobile phones from university students of healthcare professions in Rome, Italy

Mobile phones (MPs) are commonly used both in the personal and professional life. We assessed microbiological contamination of MPs from 108 students in healthcare professions (HPs), in relation to their demographic characteristics and MPs handling habits, collected by means of a questionnaire. Cultural and biochemical tests were performed, and statistical analyses were carried out. Staphylococci were present in 85% of MPs, Enterococci in 37%, Coliforms in 6.5%; E. coli was never detected. Staphylococcus epidermidis was the most frequently isolated staphylococcal species (72% of MPs), followed by S. capitis (14%), S. saprophyticus, S. warneri, S. xylosus (6%), and by S. aureus (4%). Heterotrophic Plate Counts (HPC) at 37◦C, ranged from 0 to 1.2 × 104 CFU/dm2 (mean = 362 CFU/dm2). In univariate analysis, the male gender only was significantly associated with higher HPCs and enterococcal contamination. Multiple linear regression models explained only 17% and 16% of the HPC 37◦C and staphylococcal load variability, respectively. Developing specific guidelines for a hygienic use of MPs in clinical settings, for preventing cross-infection risks, is advisable, as well as introducing specific training programs to HP students. MPs decontamination procedures could also be implemented in the community

Prevalence of nursing diagnoses as a measure of nursing complexity in a hospital setting

Aims: To describe the prevalence of nursing diagnoses on admission among inpatient units and medical diagnoses and to analyse the relationship of nursing diagnoses to patient characteristics and hospital outcomes. Background: Nursing diagnoses classify patients according to nursing dependency and can be a measure of nursing complexity. Knowledge regarding the prevalence of nursing diagnoses on admission and their relationship with hospital outcomes is lacking. Design: Prospective observational study. Methods: Data were collected for 6 months in 2014 in four inpatient units of an Italian hospital using a nursing information system and the hospital discharge register. Nursing diagnoses with prevalence higher or equal to 20% were considered as \u2018high frequency.\u2019 Nursing diagnoses with statistically significant relationships with either higher mortality or length of stay were considered as \u2018high risk.\u2019 The high-frequency/high-risk category of nursing diagnoses was identified. Results: The sample included 2283 patients. A mean of 4\ub75 nursing diagnoses per patient was identified; this number showed a statistically significant difference among inpatient units and medical diagnoses. Six nursing diagnoses were classified as high frequency/high risk. Nursing diagnoses were not correlated with patient gender and age. A statistically significant perfect linear association (Spearman's correlation coefficient) was observed between the number of nursing diagnoses and both the length of stay and the mortality rate. Conclusion: Nursing complexity, as described by nursing diagnoses, was shown to be associated with length of stay and mortality. These results should be confirmed after considering other variables through multivariate analyses. The concept of high-frequency/high-risk nursing diagnoses should be expanded in further studies

Role of PET/CT in the detection of liver metastases from colorectal cancer

The aim of this study was to compare the diagnostic accuracy of 2-[fluorine-18] fluoro-2-deoxy-D-glucose positron emission tomography (F-18-FDG-PET) and computed tomography (CT) with PET/CT in the detection of liver metastases during tumour staging in patients suffering from colorectal carcinoma for the purposes of correct surgical planning and follow-up. A total of 467 patients underwent a PET/CT scan using an iodinated contrast medium. We compared images obtained by the single PET scan, the single CT scan and by the fusion of the two procedures (PET/CT). The final diagnosis was obtained by histological examination and/or by the follow-up of all patients, including those who did not undergo surgery or biopsy. The PET scan had 94.05% sensitivity, 91.60% specificity and 93.36% accuracy; the CT scan had 91.07% sensitivity, 95.42% specificity and 92.29% accuracy. The combined procedures (PET/CT) had the following values: sensitivity 97.92%, specificity 97.71% and accuracy 97.86%. This study indicates that PET/CT is very useful in staging and restaging patients suffering from colorectal cancer. It was particularly useful when recurrences could not be visualised either clinically or by imaging despite increasing tumour markers, as it guaranteed an earlier diagnosis. PET/CT not only provides high diagnostic performance in terms of sensitivity and specificity, enabling modification of patient treatment, but it is also a unique, high-profile procedure that can produce cost savings

Appropriateness of frequent use of emergency departments: A retrospective analysis in Rome, Italy

Background: Frequent users (FUs) are patients who repeatedly and inappropriately visit the emergency department (ED) for low-grade symptoms that could be treated outside the hospital setting. This study aimed to investigate the phenomenon of the FU in Rome by profiling such users and analyzing ED attendance by FUs. Methods: The analysis was carried out for attendance in 2021 at 15 EDs in the Local Health Authority Roma 1 geographical area. A digital app collected data, including information on the following variables: number of attendance, demographic characteristics, emergency medical service (EMS) usage, triage code, and appropriateness of attendance. COVID-19 diagnosis was also studied to analyze any possible influence on ED attendance. Differences between FUs and non-FUs were investigated statistically by t-test and chi-square test. Univariate analysis and multivariable logistic regression were performed to analyze the associated factors. Results: A total of 122,762 ED attendance and 89,036 users were registered. The FU category represented 2.9% of all users, comprising 11.9% of total ED attendance. There was a three times higher frequency of non-urgent codes in attendance of FU patients (FU: 9.7%; non-FU: 3.2%). FUs were slightly more likely to have used the EMS (13.6% vs. 11.4%) and had a lower frequency of appropriate ED attendance (23.8% vs. 27.0%). Multivariate logistic analysis confirmed a significant effect of triage code, gender, age, EMS usage, and COVID-19 diagnosis for the appropriateness of attendance. The results were statistically significant (p < 0.001). Conclusion: The FU profile describes mostly non-urgent and inappropriate attendance at the ED, including during the COVID-19 pandemic. This study represents an important tool for strengthening preventive policies outside the hospital setting. The Italian National Recovery and Resilience Plan represents an excellent opportunity for the development of new strategies to mitigate the phenomenon of FUs

Obesity as a social phenomenon: A narrative review

BACKGROUND: obesity is one of the most prevalent diseases all over the world. Because of its high social impact, the broadest possible approach on several levels - and not limited only to clinical aspect - is needed to better understand and face the challenges obesity poses to public health. OBJECTIVES: to analyse, through the main evidence, the so- cial impact of weight excess in the general population and the actions aimed at mitigating its negative effects. DESIGN: narrative review. SETTING: data obtained from the sources included in the study were gathered and analyzed in five macroareas: Health Inequality, Society, Work, Impact on Social Medicine (focused on the Italian model), and Social Costs. RESULTS: each category showed a bilateral relationship with obesity having a significant impact for the community. CONCLUSIONS: for each field, various actions should be taken at institutional level. Many recommendations and actions have already been taken worldwide, but they alone seem to be not enough. This work points out that, in order to combat obesity and bring about a slowdown of this pandemic, the en- tire scientific community and institutions must work together to identify and design programmes that are truly effective

Consumo de combustible y emisiones del sector transporte aéreo en la ciudad de Rosario

El rol de las ciudades como grandes emisoras de Gases de Efecto Invernadero (GEI), determina la necesidad de estimar las emisiones relativas al consumo energético. Presentamos resultados de las emisiones de GEI en el Transporte aéreo, analizando tres métodos para el cálculo de combustible: a) Método Simplificado, b) Flight Simulator, c) Emission Inventory Guidebook. Seleccionamos como criterio el promedio de los métodos mencionados, con una incertidumbre de 8,9% con respecto a los valores extremos. El consumo anual de combustible para transporte aéreo es de 13.6 Mlitros. Para el cálculo de emisiones consideramos los cuatro criterios. Concluimos que el Método Actividad Inducida es el más apropiado con un valor total de 8.8 TnCO2equivalentes anuales. Comparamos además las emisiones de distintos medios de transporte entre Rosario-Buenos Aires con respecto al avión. El auto diésel refleja menores emisiones de GEI en un porcentaje de -98,69% y el tren de -99,90%.The role of cities as mayor contributors of Greenhouse Gases (GHG), determine the importance of measuring the relative emissions of energy consumption. In this work, we present the results of GHG emissions of aviation sector, analyzing three different methods to determine fuel consumption: a) Simplify Method, b) Flight Simulator, c) Emission Inventory Guidebook. We choose as fuel consumption criteria the average of the three mentioned methods, with 8,9% of uncertainty with respect of the extreme values. The yearly fuel consumption for aviation sector is 13.6 Ml. For the emissions calculations we analyze four methods. We come to the conclusion that the activity induced method is the more appropriate with a total value of 8.8 TnCO2eq per year. We also compare the emissions of different transportation modes from Rosario to Buenos Aires with the aviation mode. The percentage difference of a diesel car is -98.69%, and for the train is -99,90%.Tema 7: Uso eficiente y racional de la energía. Políticas y economía energética.Facultad de Arquitectura y Urbanism

Consumo de combustible y emisiones del sector transporte aéreo en la ciudad de Rosario

El rol de las ciudades como grandes emisoras de Gases de Efecto Invernadero (GEI), determina la necesidad de estimar las emisiones relativas al consumo energético. Presentamos resultados de las emisiones de GEI en el Transporte aéreo, analizando tres métodos para el cálculo de combustible: a) Método Simplificado, b) Flight Simulator, c) Emission Inventory Guidebook. Seleccionamos como criterio el promedio de los métodos mencionados, con una incertidumbre de 8,9% con respecto a los valores extremos. El consumo anual de combustible para transporte aéreo es de 13.6 Mlitros. Para el cálculo de emisiones consideramos los cuatro criterios. Concluimos que el Método Actividad Inducida es el más apropiado con un valor total de 8.8 TnCO2equivalentes anuales. Comparamos además las emisiones de distintos medios de transporte entre Rosario-Buenos Aires con respecto al avión. El auto diésel refleja menores emisiones de GEI en un porcentaje de -98,69% y el tren de -99,90%.The role of cities as mayor contributors of Greenhouse Gases (GHG), determine the importance of measuring the relative emissions of energy consumption. In this work, we present the results of GHG emissions of aviation sector, analyzing three different methods to determine fuel consumption: a) Simplify Method, b) Flight Simulator, c) Emission Inventory Guidebook. We choose as fuel consumption criteria the average of the three mentioned methods, with 8,9% of uncertainty with respect of the extreme values. The yearly fuel consumption for aviation sector is 13.6 Ml. For the emissions calculations we analyze four methods. We come to the conclusion that the activity induced method is the more appropriate with a total value of 8.8 TnCO2eq per year. We also compare the emissions of different transportation modes from Rosario to Buenos Aires with the aviation mode. The percentage difference of a diesel car is -98.69%, and for the train is -99,90%.Tema 7: Uso eficiente y racional de la energía. Políticas y economía energética.Facultad de Arquitectura y Urbanism