Stress in nursing staff: a comparative analysis between intensive care units and general medicine units

It's a current belief that stress is an outstanding feature of intensive care units, in particular within nursing staff. The aim of this study was to compare some variables belonging to stress (i.e. anxiety, depression and `Burnout' syndrome) between nurses working in intensive care units (ICUs) and general medicine units (GMUs). Materials and methods We studied a population of 883 nurses working in ICUs, distributed in 79 Italian hospitals (70.1 % female) and 509 nurses working in GMUs, distributed in 35 Italian hospitals (80.2 % female). We asked them to fill in a form including: 1) general data and his/her work environment; 2) different evaluation standardized scales - the Hospital Anxiety and Depression Scale, divided into anxiety (HAD A) and depression (HAD D) status 0-7 `non cases', 8-10 `doubtful cases', 11-21 `cases'; the S.T.A.I. scale, divided into acute anxiety (Y-1) and chronic anxiety (Y-2) status; the Maslach Burnout Inventory-Human Services Survey (MBI.) divided into Emotional Exhaustion (EE), 64 18 `low', 19-26 `average', 65 27 `high', Depersonalization (DP) and Personal Accomplishment (PA). We also evaluated the different reasons of anxiety through individual questions (higher value, more anxiety): A1, a critically ill patient; A2, a young patient; A3, an old patient; A4, a suicidal patient; A5, a terminal patient; A6, presence of mechanical supports; A7, relationship with patients' relatives. The comparison between the two groups was performed by the Mann-Whitney Rank Sum test and z-test; statistical significance was accepted as P<0.05. Results The results, expressed as median value, with 25th and 75th percentile in brackets, are shown in Tables 1 and 2. Table 1 also shows the proportions of nurses that had a highest value of HAD A and M.B.I. EE. Conclusions Pathologic anxiety and emotional exhaustion are more prevalent in nurses working in GMUs. Thus, contrary to a common belief, `stress' is a more distinctive peculiarity of general medicine units than intensive care units

Weapons in the jungle of femoro-popliteal lesions

Best treatment for Superficial Femoral Artery (SFA) lesions is still the subject of some controversies in the literature. The paper offers a brief overview of all the techniques currently available for the treatment of SFA lesions

Electroactive Inherently Chiral Surfaces at Work: Clues Toward the Elucidation of the Enantioselection Mechanism

Chirality is a concept strictly related to life and to its evolution. Capability to discriminate antipodes and/or produce enantiopure chiral chemicals through cheap and efficient protocols is a crucial task for our modern civilization. So identification of increasingly effective and robust chiral selectors is a challenging task also for the electrochemical community [1,2]. In this frame our research group is working on the so called \u201cinherently chiral functional molecular materials\u201d, ICFMMs; the idea is simple: make the stereogenic element responsible for chirality coincident with the functional group responsible for the material specific property (Figure, left). This approach has constituted an actual breakthrough in chiral electrochemistry, resulting in the preparation of efficient chiral electroactive surfaces [3,4,5] (and chiral additives/media, too [6]) invariably characterized by outstanding enantiodiscrimination ability in quite different working conditions and with chemically different chiral electroactive analytes. Notwithstanding plenty of proofs pointing to a general validity of the ICFMMs concept, a clear rationalization of the enantiodiscrimination mechanism still lacks. To fill the gap a deeper knowledge of the behavior of our electrodeposited chiral films is mandatory. As a first step some of the most important experimental parameters governing the growth of the conductive coatings have been changed, one by one, to evaluate their impact on the morphological, optical and electronic properties of the final deposit. Results of the multi-technique characterization will be discussed, including profilometry, electrochemical impedance spectroscopy (Figure, right) and spectroelectrochemistry data, all aimed to collect clues useful to rationalize the way in which ICFMMs work. The support of Fondazione Cariplo/Regione Lombardia (Project 2016-0923) and SmartMatLab are gratefully acknowledged. References: [1] S. Arnaboldi, M. Magni, P. Mussini, Curr. Opin. Electrochem., 2018, 8, 60. [2] S. Arnaboldi, S. Grecchi, M. Magni, P. Mussini, Curr. Opin. Electrochem., 2018, 7, 188. [3] F. Sannicol\uf2, P.R. Mussini, T. Benincori, R. Martinazzo, S. Arnaboldi, G. Appoloni, M. Panigati, E. Quartapelle Procopio, V. Marino, R. Cirilli, S. Casolo, W. Kutner, K. Noworyta, A. Pietrzyk-Le, Z. Iskierko, K. Bartold, Chem. Eur. J., 2016, 22, 10839. [4] S. Arnaboldi, P.R. Mussini, M. Magni, F. Sannicol\uf2, T. Benincori, R. Cirilli, K. Noworyta, W. Kutner, Chem. Sci., 2015, 6, 1706. [5] F. Sannicol\uf2, S. Arnaboldi, T. Benincori, V. Bonometti, R. Cirilli, L. Dunsch, W. Kutner, G. Longhi, P.R. Mussini, M. Panigati, M. Pierini, S. Rizzo, Angew. Chem. Int. Ed., 2014, 53, 2623. [6] S. Rizzo S. Arnaboldi, V. Mihali, R. Cirilli, A. Forni, A. Gennaro, A.A. Isse, M. Pierini, P.R. Mussini, F. Sannicol\uf2, Angew. Chem. Int. Ed., 2017, 56, 2079

Improved procedural workflow for catheter ablation of paroxysmal AF with high-density mapping system and advanced technology: Rationale and study design of a multicenter international study

The antral region of pulmonary veins (PV)s seems to play a key role in a strategy aimed at preventing atrial fibrillation (AF) recurrence. Particularly, low-voltage activity in tissue such as the PV antra and residual potential within the antral scar likely represent vulnerabilities in antral lesion sets, and ablation of these targets seems to improve freedom from AF. The aim of this study is to validate a structured application of an approach that includes the complete abolition of any antral potential achieving electrical quiescence in antral regions.The improveD procEdural workfLow for cathETEr ablation of paroxysmal AF with high density mapping system and advanced technology (DELETE AF) study is a prospective, single-arm, international post-market cohort study designed to demonstrate a low rate of clinical atrial arrhythmias recurrence with an improved procedural workflow for catheter ablation of paroxysmal AF, using the most advanced point-by-point RF ablation technology in a multicenter setting. About 300 consecutive patients with standard indications for AF ablation will be enrolled in this study. Post-ablation, all patients will be monitored with ambulatory event monitoring, starting within 30 days post-ablation to proactively detect and manage any recurrences within the 90-day blanking period, as well as Holter monitoring at 3, 6, 9, and 12 months post-ablation. Healthcare resource utilization, clinical data, complications, patients' medical complaints related to the ablation procedure and patient's reported outcome measures will be prospectively traced and evaluated.The DELETE AF trial will provide additional knowledge on long-term outcome following a structured ablation workflow, with high density mapping, advanced algorithms and local impedance technology, in an international multicentric fashion. DELETE AF is registered at ClinicalTrials.gov (NCT05005143).© 2022 The Authors. Clinical Cardiology published by Wiley Periodicals LLC

Hybrid endovascular and surgical approach for mycotic pseudoaneurysms of the extracranial internal carotid artery

Objectives: Mycotic pseudoaneurysms of the extracranial internal carotid artery are rare, and their management often represents a challenge, but treatment is necessary due to the high risk of rupture and distal brain embolization. Systemic antibiotics associated with open surgical excision of the infected tissues and carotid reconstruction using autologous grafts are the treatment of choice. The use of endovascular techniques still remains controversial in infective fields; however, it can be an attractive alternative in high-risk patients or more often as a \u201ctemporary\u201d solution to achieve immediate bleeding control for a safe surgical reconstruction. Methods: We discuss the unusual case of an extracranial right internal carotid artery mycotic pseudoaneurysm following methicillin-resistant Staphylococcus aureus infection, in a patient with poor general conditions. Results and Conclusion: The lesion was successfully treated using a hybrid endovascular and surgical procedure

Identification of pheromone components and their binding affinity to the odorant binding protein CcapOBP83a-2 of the Mediterranean fruit fly, Ceratitis capitata

The Mediterranean fruit fly (or medfly), Ceratitis capitata (Wiedemann; Diptera: Tephritidae), is a serious pest of agriculture worldwide, displaying a very wide larval host range with more than 250 different species of fruit and vegetables. Olfaction plays a key role in the invasive potential of this species. Unfortunately, the pheromone communication system of the medfly is complex and still not well established. In this study, we report the isolation of chemicals emitted by sexually mature individuals during the “calling” period and the electrophysiological responses that these compounds elicit on the antennae of male and female flies. Fifteen compounds with electrophysiological activity were isolated and identified in male emissions by gas chromatography coupled to electroantennography (GC–EAG). Within the group of 15 identified compounds, 11 elicited a response in antennae of both sexes, whilst 4 elicited a response only in female antennae. The binding affinity of these compounds, plus 4 additional compounds known to be behaviourally active from other studies, was measured using C. capitata OBP, CcapOBP83a-2. This OBP has a high homology to Drosophila melanogaster OBPs OS-E and OS-F, which are associated with trichoid sensilla and co-expressed with the well-studied Drosophila pheromone binding protein LUSH. The results provide evidence of involvement of CcapOBP83a-2 in the medfly's odorant perception and its wider specificity for (E,E)-α-farnesene, one of the five major compounds in medfly male pheromone emission. This represents the first step in the clarification of the C. capitata and pheromone reception pathway, and a starting point for further studies aimed towards the creation of new powerful attractants or repellents applicable in the actual control strategies

Association of intronic variants of the KCNAB1 gene with lateral temporal epilepsy.

The KCNAB1 gene is a candidate susceptibility factor for lateral temporal epilepsy (LTE) because of its functional interaction with LGI1, the gene responsible for the autosomal dominant form of LTE. We investigated association between polymorphic variants across the KCNAB1 gene and LTE. The allele and genotype frequencies of 14 KCNAB1 intronic SNPs were determined in 142 Italian LTE patients and 104 healthy controls and statistically evaluated. Single SNP analysis revealed one SNP (rs992353) located near the 3'end of KCNAB1 slightly associated with LTE after multiple testing correction (odds ratio=2.25; 95% confidence interval 1.26-4.04; P=0.0058). Haplotype analysis revealed two haplotypes with frequencies higher in cases than in controls, and these differences were statistically significant after permutation tests (Psim=0.047 and 0.034). One of these haplotypes was shown to confer a high risk for the syndrome (odds ratio=12.24; 95% confidence interval 1.32-113.05) by logistic regression analysis. These results support KCNAB1 as a susceptibility gene for LTE, in agreement with previous studies showing that this gene may alter susceptibility to focal epilepsy