Archivio istituzionale della ricerca - Università dell'Insubria
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A Case Series of Completely Thrombosed Abdominal Aortic Aneurysms
Get PDFBackground: Completely thrombosed AAA (th-AAA) has been infrequently described in the literature. The present study evaluated the incidence and report the outcomes of open surgical repair (OSR) of a clinical series of th-AAAs. Methods: This is a single-center, observational cohort study of consecutive th-AAAs identified between 10 October 1998, and 31 January 2024. Open repair was carried out through a transperitoneal route, and Dacron knitted graft replacement. Follow-up included the clinical visit and duplex ultrasound at 30 days, and annually thereafter. The primary outcome was overall survival. The secondary outcome was the freedom from aorta-related reintervention. Results: Out of 2237 AAA repairs, we identified 16 (0.7%) th-AAAs. They were all men with a mean age of 74 years ± 8 (range, 54–89). The median of aneurysm diameter was 49 mm (IQR, 46–52). Rupture was the presenting scenario in four (25%) patients. Early mortality and major amputation did not occur. At a mean follow-up of 70 months ± 48 (range, 11–192), the freedom from aorta-related mortality was 100%, and graft-related complications were not observed. Conclusions: The incidence of th-AAA was <1%. Although rupture was the presenting scenario in nearly 25% of the cases, OSR was safe and effective due to the absence of aorta-related mortality and the long-term durability of the repair
Letter comments on “A six-year retrospective study of patient outcomes following involved or close margin basal cell carcinoma excision” methodology clarification for better clinical application
No full textRisk factors for incomplete excision of cutaneous squamous cell carcinoma: A single-center study performed on 1082 excisions in Northern Italy
No full textCutaneous squamous cell carcinoma, which makes up for 25% of keratinocyte carcinomas, is the second most frequent skin cancer worldwide. Surgical excision via a clinical and microscopic complete resection is the treatment of choice. Incomplete excisions carry the risk of local recurrence, deep subclinical progression, and metastasis. This retrospective cohort study aimed to investigate the risk factors associated with the incomplete excision of cutaneous squamous cell carcinoma. This series included 837 patients who underwent surgical treatment for 1082 primary cutaneous squamous cell carcinoma in the Plastic Surgery Department of the Papa Giovanni XXIII Hospital in Bergamo, Northern Italy between 2012 and 2021. Patient-, procedure-, and tumor characteristics were collected and analyzed. Incomplete excision rate was 11.8% (n=128). The Pearson chi-squared test and univariable logistic regression showed tumor diameter [cm] (p<0.001), tumor thickness [mm] (p<0.001), tumor location (ear p=0.006, peri-orbital, p=0.029), differentiation grade (G3=0.005), infiltration level (hypodermis, p<0.001; muscle, p=0.013; bone/ cartilage p<0.001), presence of perineural invasion (p=0.041), ulceration (p=0.010), no prior diagnostic biopsy (p=0.041), and additional samples taken (p<0.001) with additional samples not free of tumor cells (p<0.001) to be significant risk factors/ predictors for incomplete excision. Risk factors should be considered in the management of cutaneous squamous cell carcinoma. This study documented several key contributions and confirmations regarding the risk factors associated with incomplete excision in cutaneous squamous cell carcinoma by comprehensively analyzing of one of the largest cohort studies in the field
Overseas general practitioners (GPs) and opioid prescriptions in England
Get PDFThe substantial recent rise in opioid prescription rates, along with increasing evidence of misuse and associated morbidity and mortality, raises serious concerns about the appropri- ateness of these drugs for pain management. This study investigates prescription behaviour differences across opioid drug categories between UK-trained and overseas-trained GPs. Us- ing panel data covering all English practices from 2018 to 2021, we find a strong association between practices with more overseas GPs and opioid prescription patterns. Regional dif- ferences emerge, with GPs from North America prescribing more opioids and those from Africa and Asia prescribing less, relative to the UK-trained counterparts. Heterogeneous cultural norms, different training environments, and varying epidemiological patterns might explain these different prescribing behaviours. Comprehensive cross-country assessments of GP competencies could identify areas for targeted training, helping to align the practices of foreign-trained GPs with UK standards while supporting the attraction of global talent
Effect of aspirin use on cancer incidence and mortality: An updated systematic review and meta-analysis
No full textObjectives: To evaluate the association between aspirin use and cancer incidence and mortality, and to clarify aspirin's potential role in cancer prevention. Study design: Meta-analysis of observational studies and randomized controlled trials comparing cancer outcomes in aspirin users versus non-users. Methods: A systematic literature search was performed in PubMed, Embase, and the Cochrane Library up to April 2024. Studies reporting hazard ratios (HRs) for cancer incidence or mortality in relation to aspirin use were included. Data were extracted and pooled using a random-effects model to account for study heterogeneity, and results were expressed as hazard ratios (HRs) with 95 % confidence intervals (CIs). Conclusions: This meta-analysis supports the growing body of evidence suggesting aspirin's potential role in reducing cancer incidence and mortality, particularly for colorectal and liver cancers. Future studies should focus on identifying the optimal dosage and duration of aspirin use and elucidating the mechanisms behind its protective effects to guide clinical recommendations
Hybrid pixel-based and object-based image analysis approach for landslides rapid mapping: the extreme rainfall in Emilia-Romagna (Italy) May 2023 case study
Get PDFLandslide rapid mapping inventory, generated in the immediate aftermath of severe landslide events, represents essential information for quantitative landslide risk assessment. It can support effective and efficient response in case of emergency activations, for example by identifying the potential number of affected infrastructures (e.g. roads, railways), and can provide useful information to prioritize the interventions and to guide field survey operations. Additionally, it may represent the base to be used for generating and updating landslide mapping inventories. This research presents a hybrid pixel-based and object-based image analysis approach for landslides rapid mapping using remote sensing optical multispectral imagery. The fully automated supervised procedure relies on change detection analysis, based on quantitative variation of vegetation cover, and can be applied to both aerial imagery and multiple satellites constellations acquisitions at high and very-high spatial resolution. The main novelties rely on the use of an advanced spatial filtering approach, to optimize the removal of commission errors, and a confidence measure, computed using object-oriented image analysis as a solution to optimize the accuracy of the mapping product. Investigated case study for development and testing of the procedure is the heavy rainfall event that hit Emilia-Romagna region (Italy) during May 2023. Satellite imagery acquired by Sentinel-2 and PlanetScope satellites constellations were used to generate rapid mapping products. Validation against two landslides event inventories mapped manually shows increased accuracy of the generated rapid mapping product by applying various threshold values to the confidence measure
La CEDU, le donne svizzere e il cambiamento climatico: la prospettiva del diritto costituzionale
No full textWhat is that building doing there on Via Borgo Vico? New archaeological perspectives on the Iron Age occupation of the Como (Northern Italy) lakeshores
No full textThe city of Como (Lombardia, Northern Italy) is in a plain at the interface between Lake Como and mountain
slopes. The most widely accepted narrative states that all the pre-Roman settlements were located on the hills
surrounding the Como plain, that was marshy and uninhabited. The present-day downtown lies in the plain. New
archaeological remains of a large and complex building dating back to the V cent. BC (Golasecca Culture – Iron
Age) were discovered in the “Borgo Vico” site, located in the western suburb of Como. We analysed the new
archaeological remains and re-enterpreted the available archaeological, stratigraphic, geomorphological data
and historical cartography, to reconstruct the configuration of the Iron Age settlement, and the changes of the
lake shoreline position between the Late Glacial and Iron Age/Roman Age. During these periods, the suburb was
a strategic obligatory passage between Northern Italy and Central Europe, comprising a fundamental commercial
and cultural route. In this context, the large structures could be interpreted as representative buildings. The Late
Glacial coastline gradually advanced toward the lake during the Holocene, after repeated alluvial events and
anthropogenic landfilling. Geomorphological and stratigraphic evidence and an ancient map suggest the existence
of an inlet during the Iron Age/Roman Age, potentially serving as a protected anchorage for merchants or
fishing boats. Our findings indicate a more extensive and developed human presence during the Iron Age in the
Como area than previously assumed
Rethinking plastic as a habitat modifier and a transport vector for organisms in aquatic environments
Get PDFAgroDrug Conjugates for Sustainable Crop Protection: Molecular Architectures, Mechanisms, and Critical Perspectives
Get PDFThe agriculture sector faces significant challenges from weeds and pests, exacerbated by climate change. Traditional control methods have led to the emergence of difficult to manage resistant populations, threatening global food security. AgroDrug conjugates (AgDCs) offer a promising approach to enhance agrodrug bioavailability and systemic distribution within plant tissues. This can be accomplished by attaching agrodrugs to molecular carriers such as sugars or amino acids. AgDCs aim to improve targeting and efficiency, while reducing the environmental impact. This review seeks to deliver a thorough and critical analysis of the chemical architectures and underlying mechanisms of action of AgDCs as documented in current scientific literature. Moreover, we highlight advances and knowledge gaps in AgDC design, including metabolic stability, ecological safety, and field-scale performance. Addressing these challenges will be essential to unlock the full potential of AgDCs as next-generation tools for sustainable and resilient crop protection