Low in‑hospital mortality rate in patients with COVID‑19 receiving thromboprophylaxis: data from the multicentre observational START‑COVID Register

Abstract COVID-19 infection causes respiratory pathology with severe interstitial pneumonia and extra-pulmonary complications; in particular, it may predispose to thromboembolic disease. The current guidelines recommend the use of thromboprophylaxis in patients with COVID-19, however, the optimal heparin dosage treatment is not well-established. We conducted a multicentre, Italian, retrospective, observational study on COVID-19 patients admitted to ordinary wards, to describe clinical characteristic of patients at admission, bleeding and thrombotic events occurring during hospital stay. The strategies used for thromboprophylaxis and its role on patient outcome were, also, described. 1091 patients hospitalized were included in the START-COVID-19 Register. During hospital stay, 769 (70.7%) patients were treated with antithrombotic drugs: low molecular weight heparin (the great majority enoxaparin), fondaparinux, or unfractioned heparin. These patients were more frequently affected by comorbidities, such as hypertension, atrial fibrillation, previous thromboembolism, neurological disease,and cancer with respect to patients who did not receive thromboprophylaxis. During hospital stay, 1.2% patients had a major bleeding event. All patients were treated with antithrombotic drugs; 5.4%, had venous thromboembolism [30.5% deep vein thrombosis (DVT), 66.1% pulmonary embolism (PE), and 3.4% patients had DVT + PE]. In our cohort the mortality rate was 18.3%. Heparin use was independently associated with survival in patients aged ≥ 59 years at multivariable analysis. We confirmed the high mortality rate of COVID-19 in hospitalized patients in ordinary wards. Treatment with antithrombotic drugs is significantly associated with a reduction of mortality rates especially in patients older than 59 years

Clinical features and outcomes of elderly hospitalised patients with chronic obstructive pulmonary disease, heart failure or both

Background and objective: Chronic obstructive pulmonary disease (COPD) and heart failure (HF) mutually increase the risk of being present in the same patient, especially if older. Whether or not this coexistence may be associated with a worse prognosis is debated. Therefore, employing data derived from the REPOSI register, we evaluated the clinical features and outcomes in a population of elderly patients admitted to internal medicine wards and having COPD, HF or COPD + HF. Methods: We measured socio-demographic and anthropometric characteristics, severity and prevalence of comorbidities, clinical and laboratory features during hospitalization, mood disorders, functional independence, drug prescriptions and discharge destination. The primary study outcome was the risk of death. Results: We considered 2,343 elderly hospitalized patients (median age 81 years), of whom 1,154 (49%) had COPD, 813 (35%) HF, and 376 (16%) COPD + HF. Patients with COPD + HF had different characteristics than those with COPD or HF, such as a higher prevalence of previous hospitalizations, comorbidities (especially chronic kidney disease), higher respiratory rate at admission and number of prescribed drugs. Patients with COPD + HF (hazard ratio HR 1.74, 95% confidence intervals CI 1.16-2.61) and patients with dementia (HR 1.75, 95% CI 1.06-2.90) had a higher risk of death at one year. The Kaplan-Meier curves showed a higher mortality risk in the group of patients with COPD + HF for all causes (p = 0.010), respiratory causes (p = 0.006), cardiovascular causes (p = 0.046) and respiratory plus cardiovascular causes (p = 0.009). Conclusion: In this real-life cohort of hospitalized elderly patients, the coexistence of COPD and HF significantly worsened prognosis at one year. This finding may help to better define the care needs of this population

“Vessels in the Storm”: Searching for Prognostic and Predictive Angiogenic Factors in Colorectal Cancer

High expectations are placed upon anti-angiogenic compounds for metastatic colorectal cancer (mCRC), the first malignancy for which such type of treatment has been approved. Indeed, clinical trials have confirmed that targeting the formation of new vessels can improve in many cases clinical outcomes of mCRC patients. However, current anti-angiogenic drugs are far from obtaining the desirable or expected curative results. Many are the factors probably involved in such disappointing results, but particular attention is currently focused on the validation of biomarkers able to improve the direction of treatment protocols. Because clinical studies have clearly demonstrated that serum or tissue concentration of some angiogenic factors is associated with the evolution of the disease of mCRC patients, they are currently explored as potential biomarkers of prognosis and of tumor response to therapy. However, the complex biology underlying CRC -induced angiogenesis is a hurdle in finding rapid solutions. The aim of this review was to explore molecular mechanisms that determine the formation of tumor-associated vessels during CRC progression, and to discuss the potential role of angiogenic factors as diagnostic, prognostic and predictive biomarkers in CRC

A Lagrangian Formulation of Nonholonomic Path Following

We address the problem of following an unknown planar contour with a nonholonomic vehicle based on visual feedback. The control task is to keep a point of the vehicle as close as possible to the contour for a choice of norm. A camera mounted on-board the vehicle provides measurements of the contour. We formulate the problem and compute the control law in a moving reference frame modeling the evolution of the contour as seen by an observer sitting on the vehicle. The result is an on-line path planning strategy and a predictive control law which leads the vehicle to land softly on the unknown curve. Depending on the choice of the tracking criterion, the controller can exhibit non-trivial behaviors including automatic manouvering. 1 Introduction In this paper we consider the problem of tracking an unknown contour by a nonholonomic vehicle, using visual feedback. This is a fundamental problem in autonomous navigation. The contour to be followed may be the boundary of some unknown obstacle..

The evolution of the V - K colours of single stellar populations

Models of evolutionary population synthesis of galaxies rely on the properties of the so-called single stellar populations (SSP). In this paper, we discuss how the integrated near-infrared colours - and especially V - K - of SSPs evolve with age and metallicity. Some of the uncertainties associated to the properties of the underlying stellar models are throughfully discussed. Our models include all the relevant stellar evolutionary phases, with particular attention being dedicated to the AGB, which plays a fundamental role in the evolution of the near-infrared part of the spectrum. First, we present the effects that different formulations for the mass-loss rates produce on the final remnant mass (i.e., on the initial-final mass relation), and hence on the AGB-termination luminosity and the relative contribution of these stars to the integrated light. The results for the evolution of the V - K colour are very different depending on the choice of the mass-loss prescription; the same happens also for the B - V colour in the case of low-metallicity SSPs. Second, we describe the changes occurring in the integrated colors at the onset of the AGB and RGB stars. According to the classical formalism for the AGB evolution, the onset of this evolutionary phase is marked by a color jump to the red, whose amplitude is shown here to be highly dependent on the metallicity and mass-loss rates adopted in the models. We then consider the effect of the overluminosity with respect to the standard core mass-luminosity relation, that occurs in the most massive AGB stars. Different simplified formulations for this effect are tested in the models72 refs.Available from TIB Hannover: RR 4697(1074) / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekSIGLEDEGerman

INGEGNERIA ELETTRONICA E DELLE TELECOMUNICAZIONI Lossless Compression and Interpolation for High Quality Still Images and Video Sequences

In the beginning lossless coding of still images and video sequences have been studied only for scientific purpose, such as biomedical and astronomical imagery, where even little losses could be relevant for the correct interpretation of the compressed data. In these last few years, the new technological innovations lead many professional users to the “digital world”. Professional photographers and the movie makers are day-by-day more interested to these new digital possibilities and they ask for higher image quality and the possibility to directly access the data captured by the sensor, without any automatic post-processing such as the white balance or the colour interpolation. In this thesis we present new lossless compression algorithms based upon the optimal prediction theory. We focused our research on the prediction step rather than on the prediction error modeling and context-based coding steps; in this way, we exploited all the possible correlation existing in the input images or video sequences. We started developing an optimal prediction for grayscale images, then we modified it for the colour image first, and, at the end, for the colour video sequence. We propose several way to exploit spatial, spectral and tempora