A point prevalence study of catheter associated urinary tract infections among patients admitted in an university hospital

Background: Urinary tract infections (UTIs) are the most common type of healthcare associated infection in acute care hospitals. Most involve urinary drainage devices, such as urinary catheter. The objective of this study was to investigate the prevalence of catheter-associated urinary tract infections in adult patients of a tertiary level university hospital.Methods: The point prevalence study was conducted in one single day and included all adult patients admitted in medical, surgical wards and intensive care units. The Centre for Disease Control (CDC) criteria were adopted to classify the different type of UTIs.Results: Out of a total of 497 adult inpatients, 94 patients had a urinary catheter for at least 48 hours. The prevalence of symptomatic urinary tract infection (SUTI) in this sample is 17%. Escherichia coli (31.2%), Enterococcus faecium (25.0%) and Enterococcus faecalis (12.5%) are the most common pathogens found.Conclusions: The main isolated uropathogens in this study are Gram-negative and Escherichia coli remains one of the most frequent cause of UTIs in human. Gram-negative pathogens have multiple virulent factors responsible for their adherence to uroepithelium and urinary catheter positioning facilitates the transmission of these pathogens to urinary tract. Urinary catheterization is frequently used as solution to facilitate continence and maintain skin integrity in elderly patients. Urinary incontinence frequently is an example of inappropriate use of urinary catheter: for that reason, urinary catheter should be considered as the last option if other solution, like incontinence pads, are not indicated

First discovery of orichalcum ingots from the remains of a 6th century BC shipwreck near Gela (Sicily) seabed

Ingots recently recovered from the seabed near Gela, a major harbour of Sicily, reveal an unexpected side of ancient metallurgy. The ingots were found near remains of a ship and earthenware dated around the end of the VI century BC and probably coming from the eastern Mediterranean and the Aegean sea. The ingots were analysed by means of X-Ray Fluorescence spectroscopy via a portable spectrometer. Results indicate that they are mostly consist of copper and zinc although many of them have a significant amount of lead. This alloy is nowday called brass, but in ancient time it was know as orichalcum, one of the rarest and most precious alloy along with gold and silver. Only small items of orichalcum dating before Christ were found so far. The visual examination corroborate by evaluation of dimensions and weight, are consistent with the dating hypothesis and reveals important information about the casting production. The discovery of more than twenty-two kilos of ingots is extraordinary: a first ray of light upon a forgotten technology, which involved also smelter plants (maybe more than one), a commercial network, and a number of end users, who certainly appreciated the properties of shining orichalcum: ductility, mechanical strength, durability, and value

TLR-4 and VEGF polymorphisms in chronic periaortitis

Chronic periaortitis (CP) is a rare disease that is characterised by fibro-inflammatory tissue surrounding the abdominal aorta and has both non-aneurysmal (idiopathic retroperitoneal fibrosis [IRF]) and aneurysmal forms (inflammatory abdominal aortic aneurysm [IAAA]). We investigated whether toll-like receptor 4 (TLR-4) and vascular endothelial growth factor (VEGF) polymorphisms were associated with susceptibility to, and the clinical features of CP

The heart-mind relationship in women cardiovascular primary prevention: the role of depression, anxiety, distress and Type-D personality in the 10-years cardiovascular risk evaluation

IntroductionCardiovascular diseases are the leading cause of death among women. Prevention programmes underscore the need to address women-specific risk factors. Additionally, mental well-being is a significant aspect to consider when grappling with cardiovascular disease in women, particularly depression, anxiety, distress, and personality traits. This study aimed to create “at-risk” psychological profiles for women without prior cardiovascular disease history and to evaluate the association between anxiety, depression, distress, and Type-D personality traits with increased cardiovascular risk over 10 years.Methods219 women voluntarily participated in the “Monzino Women's Heart Centre” project for primary prevention and early diagnosis of cardiovascular diseases. Psychological profiles were developed utilising cluster analysis.ResultsThe primary finding indicating that belonging to the “at-risk” psychological cluster was associated with a surge in the 10-year cardiovascular risk prediction score, despite the number of comorbid risk factors (Psychological “at-risk” cluster: β = .0674; p = .006; Risk factors: β = .0199; p = .242).ConclusionsThis finding suggests that psychological well-being of women should be assessed from the very beginning of cardiovascular prevention programmes

ICG fluorescence imaging in colorectal surgery: a snapshot from the ICRAL study group

Background: Fluorescence-guided visualization is a recently proposed technology in colorectal surgery. Possible uses include evaluating perfusion, navigating lymph nodes and searching for hepatic metastases and peritoneal spread. Despite the absence of high-level evidence, this technique has gained considerable popularity among colorectal surgeons due to its significant reliability, safety, ease of use and relatively low cost. However, the actual use of this technique in daily clinical practice has not been reported to date. Methods: This survey was conducted on April 2020 among 44 centers dealing with colorectal diseases and participating in the Italian ColoRectal Anastomotic Leakage (iCral) study group. Surgeons were approximately equally divided based on geographical criteria from multiple Italian regions, with a large proportion based in public (89.1%) and nonacademic (75.7%) centers. They were invited to answer an online survey to snapshot their current behaviors regarding the use of fluorescence-guided visualization in colorectal surgery. Questions regarding technological availability, indications and techniques, personal approaches and feelings were collected in a 23-item questionnaire. Results: Questionnaire replies were received from 37 institutions and partially answered by 8, as this latter group of centers do not implement fluorescence technology (21.6%). Out of the remaining 29 centers (78,4%), fluorescence is utilized in all laparoscopic colorectal resections by 72.4% of surgeons and only for selected cases by the remaining 27.6%, while 62.1% of respondents do not use fluorescence in open surgery (unless the perfusion is macroscopically uncertain with the naked eye, in which case 41.4% of them do). The survey also suggests that there is no agreement on dilution, dosing and timing, as many different practices are adopted based on personal judgment. Only approximately half of the surgeons reported a reduced leak rate with fluorescence perfusion assessment, but 65.5% of them strongly believe that this technique will become a minimum requirement for colorectal surgery in the future. Conclusion: The survey confirms that fluorescence is becoming a widely used technique in colorectal surgery. However, both the indications and methods still vary considerably; furthermore, the surgeons' perceptions of the results are insufficient to consider this technology essential. This survey emphasizes the need for further research to reach recommendations based on solid scientific evidence. Keywords: Colon cancer; Fluorescence guided surgery; ICG; Laparoscopy; Rectal cancer

An exploratory study on counterfactual thinking in amyotrophic lateral sclerosis

ObjectivesThis study aimed at exploring (1) the motor and non-motor correlates of counterfactual thinking (CFT) abilities in non-demented amyotrophic lateral sclerosis (ALS) patients and (2) the ability of CFT measures to discriminate these patients from healthy controls (HCs) and patients with and without cognitive impairment.MethodsN = 110 ALS patients and N = 51 HCs were administered two CFT tasks, whose sum, resulting in a CFT Index (CFTI), was addressed as the outcome. Patients further underwent an in-depth cognitive, behavioral, and motor-functional evaluation. Correlational analyses were run to explore the correlates of the CFTI in patients. Logistic regressions were performed to test whether the CFTI could discriminate patients from HCs.ResultsThe CFTI was selectively associated (p ≤ 0.005) with fluency and memory subscales of the Edinburgh Cognitive and Behavioral ALS Screen (ECAS), but not with other variables. CFTI scores discriminated patients from HCs (p < 0.001) with high accuracy (82%), but not patients with a normal vs. defective performance on the ECAS-Total.ConclusionCFT measures in non-demented ALS patients were associated with verbal fluency and memory functions, and they were also able to discriminate them from HCs

Rates and Predictors of Treatment Failure in Staphylococcus aureus Prosthetic Joint Infections According to Different Management Strategies: A Multinational Cohort Study—The ARTHR-IS Study Group

Introduction: Guidelines have improved the management of prosthetic joint infections (PJI). However, it is necessary to reassess the incidence and risk factors for treatment failure (TF) of Staphylococcus aureus PJI (SA-PJI) including functional loss, which has so far been neglected as an outcome. Methods: A retrospective cohort study of SA-PJI was performed in 19 European hospitals between 2014 and 2016. The outcome variable was TF, including related mortality, clinical failure and functional loss both after the initial surgical procedure and after all procedures at 18 months. Predictors of TF were identified by logistic regression. Landmark analysis was used to avoid immortal time bias with rifampicin when debridement, antibiotics and implant retention (DAIR) was performed. Results: One hundred twenty cases of SA-PJI were included. TF rates after the first and all surgical procedures performed were 32.8% and 24.2%, respectively. After all procedures, functional loss was 6.0% for DAIR and 17.2% for prosthesis removal. Variables independently associated with TF for the first procedure were Charlson >= 2, haemoglobin 30 kg/m(2) and delay of DAIR, while rifampicin use was protective. For all procedures, the variables associated with TF were haemoglobin < 10 g/dL, hip fracture and additional joint surgery not related to persistent infection. Conclusions: TF remains common in SA-PJI. Functional loss accounted for a substantial proportion of treatment failures, particularly after prosthesis removal. Use of rifampicin after DAIR was associated with a protective effect. Among the risk factors identified, anaemia and obesity have not frequently been reported in previous studies. [GRAPHICS]

Rapporto sull'efficienza energetica 2013

Rapporto tecnico sulla gestione energetica nelle grandi strutture del CNR e sui possibili interventi per la riduzione dei consumi (258 pagine, con contributi di 25 autori). Pubblicazione del progetto “Efficienza energetica”, promosso dal Direttore Generale del CNR con lettera prot. CNR n. 0075888 del 7/12/2012

Dupilumab in the treatment of severe uncontrolled chronic rhinosinusitis with nasal polyps (CRSwNP): A multicentric observational Phase IV real-life study (DUPIREAL)

Background Chronic rhinosinusitis with nasal polyps (CRSwNP) is associated with significant morbidity and reduced health-related quality of life. Findings from clinical trials have demonstrated the effectiveness of dupilumab in CRSwNP, although real-world evidence is still limited. Methods This Phase IV real-life, observational, multicenter study assessed the effectiveness and safety of dupilumab in patients with severe uncontrolled CRSwNP (n = 648) over the first year of treatment. We collected data at baseline and after 1, 3, 6, 9, and 12 months of follow-up. We focused on nasal polyps score (NPS), symptoms, and olfactory function. We stratified outcomes by comorbidities, previous surgery, and adherence to intranasal corticosteroids, and examined the success rates based on current guidelines, as well as potential predictors of response at each timepoint. Results We observed a significant decrease in NPS from a median value of 6 (IQR 5–6) at baseline to 1.0 (IQR 0.0–2.0) at 12 months (p &lt; .001), and a significant decrease in Sino-Nasal Outcomes Test-22 (SNOT-22) from a median score of 58 (IQR 49–70) at baseline to 11 (IQR 6–21; p &lt; .001) at 12 months. Sniffin' Sticks scores showed a significant increase over 12 months (p &lt; .001) compared to baseline. The results were unaffected by concomitant diseases, number of previous surgeries, and adherence to topical steroids, except for minor differences in rapidity of action. An excellent-moderate response was observed in 96.9% of patients at 12 months based on EPOS 2020 criteria. Conclusions Our findings from this large-scale real-life study support the effectiveness of dupilumab as an add-on therapy in patients with severe uncontrolled CRSwNP in reducing polyp size and improving the quality of life, severity of symptoms, nasal congestion, and smell

From Academia Armena Sancti Lazari to the Establishment of Armenian Studies at Ca’ Foscari

The Armenian Studies have a very long tradition in Italy. However, the establishment of the official teaching of Armenian at Ca’ Foscari is particularly significant. It is a direct continuation of many Armenian traces present in the lagoon city for centuries, such as the birth of the first Casa Armena in Europe in 1245, the prosperous diplomatic relations between the Republic of Serenissima and the Kingdom of Armenia, the printing of the first Armenian book in 1512, the arrival of Armenian merchants from Julfa, who highly contributed to the economy of Venice, and finally the institution of the Mekhitarist Congregation of the Armenian monks on the island of San Lazzaro, recognised by Napoleon as Academia Armena Sancti Lazari. After an historical excursus, the paper will go on to detail some significant periods of Armenian Studies at Ca’ Foscari