103 research outputs found

    Prevalence and risk factors for chronic obstructive lung disease in HIV-infected patients in the HAART era

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    Our results suggest a role for HIV infection itself and for current cigarette smoking in the development of respiratory symptoms and COPD in HIV-infected patients. HAART did not seem to reduce the risk of respiratory symptoms and COPD, in our cases. Thus, our results suggest that HIV-infected patients should be screened for chronic respiratory disease in order to early identify those at risk or those who need specific treatment

    Assessment of asthma severity in adults with ever asthma: a continuous score

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    Background In epidemiological studies, continuous measures of asthma severity should be used to catch the heterogeneity of phenotypes. This study aimed at developing and validating continuous measures of asthma severity in adult patients with ever asthma from the general population, to be used in epidemiological studies. Methods Respiratory symptoms, anti-asthmatic treatment and lung function were measured on 520 patients with ever asthma aged 20–64 years from the general Italian population (GEIRD study; 2007/2010). The variables that represent the same dimension of asthma severity were identified through an exploratory factor analysis and were summarized through a multiple factor analysis. Results Only respiratory symptoms and anti-asthmatic treatment were summarized in a continuous score (STS). STS ranges from 0 (no symptoms/treatment) to 10 (maximum symptom frequency and treatment intensity). STS was positively correlated with the Global Initiative for Asthma classification of asthma severity computed on the 137 cases with a doctor's diagnosis (Spearman’s coefficient = 0.61, p-value<0.0001) (concurrent validity). Furthermore, using a cohort of 1,097 European asthmatics (ECRHS II study; 1999/2002), increasing STS levels at baseline (1991/1993) were positively associated with long-term outcomes (hospitalization and lost workdays for breathing problems, asthma attack frequency and use of asthma controllers) (predictive validity). Finally, the STS scores computed from the GEIRD and ECRHS II data were comparable (Lin’s coefficient = 0.95, p-value<0.0001) (replication analysis). Conclusions STS is a valid and replicable measure of asthma severity in adults, which could be used in association studies

    Olfactory and gustatory function impairment in COVID-19 patients : Italian objective multicenter-study

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    Background: Objective data on chemosensitive disorders during COVID-19 are lacking in the Literature. Methods: Multicenter cohort study that involved four Italian hospitals. Three hundred and forty-five COVID-19 patients underwent objective chemosensitive evaluation. Results: Chemosensitive disorders self-reported by 256 patients (74.2%) but the 30.1% of the 89 patients who did not report dysfunctions proved objectively hyposmic. Twenty-five percentage of patients were seen serious long-lasting complaints. All asymptomatic patients had a slight lowering of the olfactory threshold. No significant correlations were found between the presence and severity of chemosensitive disorders and the severity of the clinical course. On the contrary, there is a significant correlation between the duration of the olfactory and gustatory symptoms and the development of severe COVID-19. Conclusions: Patients under-report the frequency of chemosensitive disorders. Contrary to recent reports, such objective testing refutes the proposal that the presence of olfactory and gustatory dysfunction may predict a milder course, but instead suggests that those with more severe disease neglect such symptoms in the setting of severe respiratory disease

    Cytological and histological diagnosis of lung cancer in Sardinia and Italy in the 1990s

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    Background. Up to 30-50% of all lung cancer cases remain without cyto-histological characterisation. The aim of our study was to evaluate retrospectively the proportion of histological and/or cytological diagnosis in patients with lung cancer in Sardinia. Methods. Data was gathered by consulting the hospital registers and case notes of individual patients released from hospital with a diagnosis of Lung Cancer at all medical centres throughout Sardinia. In gathering patients' data, we focused our attention on cytological and histological procedures through which allowed the lung cancer was diagnosed. Cancer Registries data was utilised to compare our data with national and Sassari province data. Results. From 1991 to 1996 there was a total of 3146 lung cancer patients registered in Sardinia. 1902 patients (60.5%) had a histological diagnosis, 142 patients (4.5%) a cytological diagnosis while in 1102 patients (35%) the diagnosis was performed without any pathological validation. Conclusions. Our study has shown that lung cancer diagnosis is supported by pathological verification in 65% of cases while in remaining 35% of patients the diagnosis is based only on clinical and radiological reports. In Italy data from Cancer Registries report the percentage of cyto- histological diagnosis to be 70% with the percentage of cytological diagnosis being higher than in Sardinia

    Covid-19 and the role of smoking: The protocol of the multicentric prospective study COSMO-IT (covid19 and smoking in italy)

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    The emergency caused by Covid-19 pandemic raised interest in studying lifestyles and comorbidities as important determinants of poor Covid-19 prognosis. Data on tobacco smoking, alcohol consumption and obesity are still limited, while no data are available on the role of e-cigarettes and heated tobacco products (HTP). To clarify the role of tobacco smoking and other lifestyle habits on COVID-19 severity and progression, we designed a longitudinal observational study titled COvid19 and SMOking in ITaly (COSMO-IT). About 30 Italian hospitals in North, Centre and South of Italy joined the study. Its main aims are: 1) to quantify the role of tobacco smoking and smoking cessation on the severity and progression of COVID-19 in hospitalized patients; 2) to compare smoking prevalence and severity of the disease in relation to smoking in hospitalized COVID-19 patients versus patients treated at home; 3) to quantify the association between other lifestyle factors, such as e-cigarette and HTP use, alcohol and obesity and the risk of unfavourable COVID-19 outcomes. Socio-demographic, lifestyle and medical history information will be gathered for around 3000 hospitalized and 700-1000 home-isolated, laboratory-confirmed, COVID-19 patients. Given the current absence of a vaccine against SARS-COV-2 and the lack of a specific treatment for COVID-19, prevention strategies are of extreme importance. This project, designed to highly contribute to the international scientific debate on the role of avoidable lifestyle habits on COVID-19 severity, will provide valuable epidemiological data in order to support important recommendations to prevent COVID-19 incidence, progression and mortality

    Adrenal function recovery after durable oral corticosteroid sparing with benralizumab in the PONENTE study

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    Background Oral corticosteroid (OCS) dependence among patients with severe eosinophilic asthma can cause adverse outcomes, including adrenal insufficiency. PONENTE's OCS reduction phase showed that, following benralizumab initiation, 91.5% of patients eliminated corticosteroids or achieved a final dosage ≀5 mg·day-1 (median (range) 0.0 (0.0-40.0) mg). Methods The maintenance phase assessed the durability of corticosteroid reduction and further adrenal function recovery. For ~6 months, patients continued benralizumab 30 mg every 8 weeks without corticosteroids or with the final dosage achieved during the reduction phase. Investigators could prescribe corticosteroids for asthma exacerbations or increase daily dosages for asthma control deteriorations. Outcomes included changes in daily OCS dosage, Asthma Control Questionnaire (ACQ)-6 and St George's Respiratory Questionnaire (SGRQ), as well as adrenal status, asthma exacerbations and adverse events. Results 598 patients entered PONENTE; 563 (94.1%) completed the reduction phase and entered the maintenance phase. From the end of reduction to the end of maintenance, the median (range) OCS dosage was unchanged (0.0 (0.0-40.0) mg), 3.2% (n=18/563) of patients experienced daily dosage increases, the mean ACQ-6 score decreased from 1.26 to 1.18 and 84.5% (n=476/563) of patients were exacerbation free. The mean SGRQ improvement (-19.65 points) from baseline to the end of maintenance indicated substantial quality-of-life improvements. Of patients entering the maintenance phase with adrenal insufficiency, 32.4% (n=104/321) demonstrated an improvement in adrenal function. Adverse events were consistent with previous reports. Conclusions Most patients successfully maintained maximal OCS reduction while achieving improved asthma control with few exacerbations and maintaining or recovering adrenal function

    STRATIGRAFIE DI TERRA E STORIA IN VALBRENTA. LAYERING OF GEOGRAPHY AND HISTORY IN VALBRENTA

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    Esiti del WaVe dell'UniversitĂ  Iuav di Venezi

    Con occhi di straniero. Riscoprire il paesaggio attraverso immagini e racconti della Grande Guerra

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    Il testo propone una riflessione sulla riscoperta dei paesaggi della prima guerra mondiale attraverso immagini e racconti. L'educazione a 'vedere' ù considerata punto di partenza per un buon progetto. Riuscire a vedere comporta la necessità di mettere in relazione differenti livelli e tipi di lettura, al fine di riconoscere quanto e come “natura e cultura hanno interagito nei processi di costruzione del paesaggio e nelle pratiche sociali con le quali quel paesaggio ù stato interpretato e utilizzato” e di individuare quali tecniche di rappresentazione consentano di restituire tale complessità. Le immagini costituiscono uno degli elementi che permettono di far emergere frammenti di verità, ma al contempo di suscitare stati d’animo. L’occhio strategico dell’architetto deve essere utilizzato nell’esercizio paziente del guardare, osservare e vedere per poter scoprire, immaginare, inventare e infine creare. Un lavoro di osservazione inteso come inizio e parte del lavoro progettuale, per accumulare esperienze alle quali potersi riferire nel progetto, per assimilare e appropriarsi di “frammenti di verità”, per allenare l’occhio e la mente

    Viaggio nel tempo. Rappresentazioni di guerra e impronte nel paesaggio

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    La geografia militare rappresenta uno dei pilastri dell’arte militare fornendo un supporto fondamentale per la pianificazione e la conduzione della guerra. Non a caso la cartografia Ăš rimasta confinata per secoli quasi esclusivamente all’interno degli istituti militari di tanti paesi, compresi quelli delle nazioni belligeranti sul fronte italiano. BenchĂ© gli avvenimenti storici siano strettamente interconnessi alla geografia dei luoghi, troppo spesso l’elemento topografico Ăš stato trascurato, se non addirittura omesso, dall’analisi storica. Il testo propone una lettura del significato della geografia e cartografia secondo lo sguardo dell'architetto interessato al progetto in luoghi segnati dai tragici eventi della prima guerra mondiale. Il volume incrocia in tale senso sguardi e modalitĂ  di lettura differenti a partire dalla multidisciplinarietĂ  degli autori: geografi, storici e architetti
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