30 research outputs found

    Intraocular pressure in silicon-oil tamponated eyes using a non-contact pulse synchronous tonometer: IOP measurement in vitrectomized and silicon-oil tamponated eyes by NT-4000

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    Objective To assess the reliability of intraocular pressure (IOP)measurement by means of NidekNT - 4000 tonometer in vitrectomized and siliconoil tamponaded (VSOT)eyes. Methods IOP was measured by means of NidekNT - 4000 and compared with standard Goldmann applanation tonometer (GAT)in 36 consecutive VSOT eyes and 36 normal eyes. Results In VSOT and nor mal eyes NidekNT - 4000 showed agreement with GAT (VSOT eyes mean difference:1. 83 ± 2. 64,P = 0 55;correlation:P < 0 0001,r = 0 95;Normal eyes mean difference:1 ± 2 8,P = 0 42;correlation:P = 0 0045,r = 0 69 ). Differences were similar be tween groups (P = 0 81). Conclusions NidekNT - 4000 tonometer offers a new affordable method to measure IOP in vitrectomized and siliconoil tamponaded eyes

    A novel approach to noisy gates for simulating quantum computers

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    We present a novel method for simulating the noisy behaviour of quantum computers, which allows to efficiently incorporate environmental effects in the driven evolution implementing the gates acting on the qubits. We show how to modify the noiseless gate executed by the computer to include any Markovian noise, hence resulting in what we will call a noisy gate. We compare our method with the IBM Qiskit simulator, and show that it follows more closely both the analytical solution of the Lindblad equation as well as the behaviour of a real quantum computer, where we ran algorithms involving up to 18 qubits; as such, our protocol offers a more accurate simulator for NISQ devices. The method is flexible enough to potentially describe any noise, including non-Markovian ones. The noise simulator based on this work is available as a python package at this link: https://pypi.org/project/quantum-gates

    Beta-Blocker Use in Older Hospitalized Patients Affected by Heart Failure and Chronic Obstructive Pulmonary Disease: An Italian Survey From the REPOSI Register

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    Beta (β)-blockers (BB) are useful in reducing morbidity and mortality in patients with heart failure (HF) and concomitant chronic obstructive pulmonary disease (COPD). Nevertheless, the use of BBs could induce bronchoconstriction due to β2-blockade. For this reason, both the ESC and GOLD guidelines strongly suggest the use of selective β1-BB in patients with HF and COPD. However, low adherence to guidelines was observed in multiple clinical settings. The aim of the study was to investigate the BBs use in older patients affected by HF and COPD, recorded in the REPOSI register. Of 942 patients affected by HF, 47.1% were treated with BBs. The use of BBs was significantly lower in patients with HF and COPD than in patients affected by HF alone, both at admission and at discharge (admission, 36.9% vs. 51.3%; discharge, 38.0% vs. 51.7%). In addition, no further BB users were found at discharge. The probability to being treated with a BB was significantly lower in patients with HF also affected by COPD (adj. OR, 95% CI: 0.50, 0.37-0.67), while the diagnosis of COPD was not associated with the choice of selective β1-BB (adj. OR, 95% CI: 1.33, 0.76-2.34). Despite clear recommendations by clinical guidelines, a significant underuse of BBs was also observed after hospital discharge. In COPD affected patients, physicians unreasonably reject BBs use, rather than choosing a β1-BB. The expected improvement of the BB prescriptions after hospitalization was not observed. A multidisciplinary approach among hospital physicians, general practitioners, and pharmacologists should be carried out for better drug management and adherence to guideline recommendations

    Antidiabetic Drug Prescription Pattern in Hospitalized Older Patients with Diabetes

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    Objective: To describe the prescription pattern of antidiabetic and cardiovascular drugs in a cohort of hospitalized older patients with diabetes. Methods: Patients with diabetes aged 65 years or older hospitalized in internal medicine and/or geriatric wards throughout Italy and enrolled in the REPOSI (REgistro POliterapuie SIMI—Società Italiana di Medicina Interna) registry from 2010 to 2019 and discharged alive were included. Results: Among 1703 patients with diabetes, 1433 (84.2%) were on treatment with at least one antidiabetic drug at hospital admission, mainly prescribed as monotherapy with insulin (28.3%) or metformin (19.2%). The proportion of treated patients decreased at discharge (N = 1309, 76.9%), with a significant reduction over time. Among those prescribed, the proportion of those with insulin alone increased over time (p = 0.0066), while the proportion of those prescribed sulfonylureas decreased (p &lt; 0.0001). Among patients receiving antidiabetic therapy at discharge, 1063 (81.2%) were also prescribed cardiovascular drugs, mainly with an antihypertensive drug alone or in combination (N = 777, 73.1%). Conclusion: The management of older patients with diabetes in a hospital setting is often sub-optimal, as shown by the increasing trend in insulin at discharge, even if an overall improvement has been highlighted by the prevalent decrease in sulfonylureas prescription

    The “Diabetes Comorbidome”: A Different Way for Health Professionals to Approach the Comorbidity Burden of Diabetes

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    (1) Background: The disease burden related to diabetes is increasing greatly, particularly in older subjects. A more comprehensive approach towards the assessment and management of diabetes’ comorbidities is necessary. The aim of this study was to implement our previous data identifying and representing the prevalence of the comorbidities, their association with mortality, and the strength of their relationship in hospitalized elderly patients with diabetes, developing, at the same time, a new graphic representation model of the comorbidome called “Diabetes Comorbidome”. (2) Methods: Data were collected from the RePoSi register. Comorbidities, socio-demographic data, severity and comorbidity indexes (Cumulative Illness rating Scale CIRS-SI and CIRS-CI), and functional status (Barthel Index), were recorded. Mortality rates were assessed in hospital and 3 and 12 months after discharge. (3) Results: Of the 4714 hospitalized elderly patients, 1378 had diabetes. The comorbidities distribution showed that arterial hypertension (57.1%), ischemic heart disease (31.4%), chronic renal failure (28.8%), atrial fibrillation (25.6%), and COPD (22.7%), were the more frequent in subjects with diabetes. The graphic comorbidome showed that the strongest predictors of death at in hospital and at the 3-month follow-up were dementia and cancer. At the 1-year follow-up, cancer was the first comorbidity independently associated with mortality. (4) Conclusions: The “Diabetes Comorbidome” represents the perfect instrument for determining the prevalence of comorbidities and the strength of their relationship with risk of death, as well as the need for an effective treatment for improving clinical outcomes

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

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    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

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

    Get PDF
    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&nbsp;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

    Noisy gates approach for simulating quantum computers

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    In the seminar we present a novel method for simulating the noisy&nbsp;behavior of quantum computers, which allows to efficiently incorporate&nbsp;environmental effects in the driven evolution implementing the gates on&nbsp;the qubits. We show how to modify the noiseless gate executed by the&nbsp;computer to include any Markovian noise, hence resulting in what we will&nbsp;call a noisy gate. We test our method against the IBM Qiskit simulator and&nbsp;show that it follows more closely both the analytical evolution of the&nbsp;Lindblad equation as well as the behavior of a real quantum computer, thus&nbsp;offering a more accurate noise simulator of NISQ devices. The method is&nbsp;flexible enough to potentially describe any noise, including non-Markovian&nbsp;ones.About the speakersGiovanni di Bartolomeo and Michele Vischi are PhD students in the QMTS group at the University of Trieste. They are working together on the development of new techniques for the analysis of noise in quantum algorithms and error mitigation strategies.Giovanni's main research interests are quantum information, open quantum systems and models of wave function collapse related to gravity.Michele's main research interests are quantum computation, decoherence in quantum devices, and superconducting quantum circuits.Collaborators&nbsp;Francesco Cesa, Roman Wixinger, Michele Grossi, Sandro Donadi, Angelo Bassi</p
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