64 research outputs found
sj-pdf-1-wso-10.1177_17474930241245828 – Supplemental material for Baseline clinical and neuroradiological predictors of outcome in patients with large ischemic core undergoing mechanical thrombectomy: A retrospective multicenter study
No full textSupplemental material, sj-pdf-1-wso-10.1177_17474930241245828 for Baseline clinical and neuroradiological predictors of outcome in patients with large ischemic core undergoing mechanical thrombectomy: A retrospective multicenter study by Andrea M Alexandre, Mauro Monforte, Valerio Brunetti, Luca Scarcia, Luigi Cirillo, Andrea Zini, Irene Scala, Vincenzo Nardelli, Francesco Arbia, Giuseppe Arbia, Giovanni Frisullo, Erwah Kalsoum, Arianna Camilli, Davide De Leoni, Francesca Colò, Serena Abruzzese, Mariangela Piano, Claudia Rollo, Antonio Macera, Maria Ruggiero, Elvis Lafe, Joseph D Gabrieli, Giacomo Cester, Nicola Limbucci, Francesco Arba, Simone Ferretti, Valerio Da Ros, Luigi Bellini, Giancarlo Salsano, Nicola Mavilio, Riccardo Russo, Mauro Bergui, Antonio A Caragliano, Sergio L Vinci, Daniele G Romano, Giulia Frauenfelder, Vittorio Semeraro, Maria P Ganimede, Emilio Lozupone, Andrea Romi, Anna Cavallini, Luca Milonia, Massimo Muto, Paolo Candelaresi, Paolo Calabresi, Alessandro Pedicelli and Aldobrando Broccolini in International Journal of Stroke</p
Ruolo dell'obesità materna sul rischio di sviluppo di obesità infantile: uno studio integrato
No full textIntroduzione: Oltre il 60% dei bambini sono in sovrappeso e questo è un fattore di rischio per lo sviluppo di patologie dismetaboliche e degenerative. Diverse ricerche hanno mostrato che obesità e/o disturbi psicopatologici di un genitore, in particolare la madre, rappresentano fattori di rischio per l’obesità dei figli. Questo succede attraverso vie dirette ed indirette, tra cui stili alimentari familiari e un pattern di regolazione alimentare predisponenti all’obesità. In questo studio abbiamo verificato il ruolo di fattori di rischio comportamentali e biologici potenzialmente trasmissibili da madre in figlio dall’ottavo mese di gestazione.
Materiali e metodi: Nel sangue delle gravide e in quello cordonale della loro prole sono stati dosati leptina, IGF1 e markers dello stress ossidativo: la leptina promuove la formazione dei circuiti neurali che controllano l’intake di cibo e l’adiposità successivamente, nel sangue cordonale è inversamente correlata al livello di crescita intrauterino. L'IGF-1 è importante per i processi di crescita del bambino ed ha effetti anabolici in età adulta. Numerosi studi hanno evidenziato una relazione tra obesità e stress ossidativo con un’ alterazione delle difese antiossidanti. Per gli aspetti psicologici abbiamo sottoposto le donne ad un test di personalità, i bambini ad uno sul temperamento ed è stato videoregistrata ed analizzata una seduta di allattamento al secondo mese di vita del bambino.
Risultati:Disturbi di somatizzazione, ansia e del sonno risultano più frequenti nelle donne obese rispetto alle normopeso, mentre le modalità relazionali durante il pasto sono risultate meno adeguate per la mancanza di scambi comunicativi ed affettivi positivi. I dati ottenuti hanno evidenziato livelli minori dell’attività antiossidante nel plasma delle donne obese e nel sangue cordonale dei figli. I dati confermano che l’obesità è associata a iperleptinemia. Valori piu’ elevati di leptina sono stati osservati anche nel sangue del cordone ombelicale dei figli delle donne obese. Nelle obese i livelli di IGF1 sono minori rispetto alle donne normopeso.
Conclusioni: Questi dati suggeriscono la necessità di ampliare la casistica di ricerca e proseguire longitudinalmente lo studi
The Gran Teatre del Liceu in Catalan Culture: History, Representation and Myth
No full textThe copyright of this thesis rests with the author and no quotation from it or information derived from it may be published without the prior written consent of the authorThis thesis examines the position of Barcelona’s Gran Teatre del Liceu within Barcelona’s cultural lanscapeas a means of exploring its modern-day role as one of Europe’s most important opera houses. Other studies of the Liceu have provided extensive historical narratives, but have rarely considered any kind of sociological or cultural theory when analysing the theatre’s role in the city.
Chapter 1 explores the Liceu in Spanish and Catalan literature and dramaturgy and questions its role as a representative of upper-class Barcelona culture, and the changes this role has undergone over the course of Spain’s transition to democracy.
The Liceu’s location in the adjacent Raval district is examined in Chapter 2: the area has undergone considerable physical and demographic changes over the last decades, and the opera house’s relationship to this area and the larger Barcelona context is discussed in some detail.
The third chapter contextualises the Liceu within the wider Catalan cultural panorama and examines the impact of the recession in Spain, which has greatly affected cultural spending, and consequently the theatre’s programme. This problem has been aggravated by an awkward, opaque system of management; the thesis provides examples and analysis of the difficulties the theatre experienced between 2010 and 2013.
The final chapter seeks to underline the efforts of the artistic direction to make the Liceu a referent of modern European operatic productions, with three case studies of stagings that represent modern interpretations of opera by contemporary Catalan directors. These works have been chosen as representative of the Liceu’s determined modernisation of the operatic spectacle and of its commitment to local artists.
The thesis aims to present a more critical view of Barcelona’s opera house that goes beyond chronological narrative and anecdote in depicting the modern-day situation of the institution and its place in the Barcelona context.funded by an Arts and Humanities Research Council Collaborative Doctoral Award with the Gran Teatre del Lice
Predictors of parenchymal hematoma and clinical outcome after mechanical thrombectomy in patients with large ischemic core due to large vessel occlusion: a retrospective multicenter study
No full textBackgroundThe aim of our study was to find predictors of parenchymal hematoma (PH) and clinical outcome after mechanical thrombectomy (MT) in patients with large vessel occlusion (LVO) and baseline large infarct.MethodsThe databases of 16 stroke centers were retrospectively screened for patients with anterior circulation LVO and baseline Alberta Stroke Program Early CT Score (ASPECTS) ≤5 that received MT. Procedural parameters, including the number of passes during first and second technique of MT, were recorded. Outcome measures were occurrence of PH type 2 and any type of PH after MT, and the 90-day modified Rankin Scale (mRS) score of 0–3 and 0–2.ResultsIn total, 408 patients were available for analysis. A higher number of passes in the second technique was predictive of PH type 2 (odds ratio (OR) - 3.204, 95% confidence interval (CI) 1.140 to 9.005), whereas procedure conducted under general anesthesia was associated with lower risk (OR 0.127, 95% CI 0.002 to 0.808). The modified thrombolysis in cerebral infarction grade 2c-3 was associated with the mRS score 0–3 (OR 3.373, 95% CI 1.891 to 6.017), whereas occurrence of PH type 2 was predictive of unfavorable outcome (OR 0.221, 95% CI 0.063 to 0.773). Similar results were found for the mRS score 0–2 outcome measure.ConclusionIn patients with large ischemic core, a higher number of passes during MT and procedure not conducted under general anesthesia are associated with increased rate of PH type 2, that negatively impact the clinical outcome. Our data outline a delicate balance between the need of a complete recanalization and the risk of PH following MT
Clinical Features Associated with Delirium Motor Subtypes in Older Inpatients: Results of a Multicenter Study
No full textObjective To date motor subtypes of delirium have been evaluated in single-center studies with a limited examination of the relationship between predisposing factors and motor profile of delirium. We sought to report the prevalence and clinical profile of subtypes of delirium in a multicenter study. Methods This is a point prevalence study nested in the âDelirium Day 2015â, which included 108 acute and 12 rehabilitation wards in Italy. Delirium was detected using the 4-AT and motor subtypes were measured with the Delirium Motor Subtype Scale (DMSS). A multinomial logistic regression was used to determine the factors associated with delirium subtypes. Results Of 429 patients with delirium, the DMSS was completed in 275 (64%), classifying 21.5% of the patients with hyperactive delirium, 38.5% with hypoactive, 27.3% with mixed and 12.7% with the non-motor subtype. The 4-AT score was higher in the hyperactive subtype, similar in the hypoactive, mixed subtypes, while it was lowest in the non-motor subtype. Dementia was associated with all three delirium motor subtypes (hyperactive, OR 3.3, 95% CI: 1.2-8.7; hypoactive, OR 2.8, 95% CI: 1.2-6.5; mixed OR 2.6, 95% CI: 1.1-6.2). Atypical antipsychotics were associated with hypoactive delirium (OR 0.23, 95% CI: 0.1-0.7), while intravenous lines were associated with mixed delirium (OR 2.9, 95% CI: 1.2-6.9). Conclusions The study shows that hypoactive delirium is the most common subtype among hospitalized older patients. Specific clinical features were associated with different delirium subtypes. The use of standardized instruments can help to characterize the phenomenology of different motor subtypes of delirium
Recommendations for self-monitoring in pediatric diabetes: A consensus statement by the ISPED
No full text"Delirium Day": A nationwide point prevalence study of delirium in older hospitalized patients using an easy standardized diagnostic tool
No full textBackground: To date, delirium prevalence in adult acute hospital populations has been estimated generally from pooled findings of single-center studies and/or among specific patient populations. Furthermore, the number of participants in these studies has not exceeded a few hundred. To overcome these limitations, we have determined, in a multicenter study, the prevalence of delirium over a single day among a large population of patients admitted to acute and rehabilitation hospital wards in Italy. Methods: This is a point prevalence study (called "Delirium Day") including 1867 older patients (aged 65 years or more) across 108 acute and 12 rehabilitation wards in Italian hospitals. Delirium was assessed on the same day in all patients using the 4AT, a validated and briefly administered tool which does not require training. We also collected data regarding motoric subtypes of delirium, functional and nutritional status, dementia, comorbidity, medications, feeding tubes, peripheral venous and urinary catheters, and physical restraints. Results: The mean sample age was 82.0 ± 7.5 years (58 % female). Overall, 429 patients (22.9 %) had delirium. Hypoactive was the commonest subtype (132/344 patients, 38.5 %), followed by mixed, hyperactive, and nonmotoric delirium. The prevalence was highest in Neurology (28.5 %) and Geriatrics (24.7 %), lowest in Rehabilitation (14.0 %), and intermediate in Orthopedic (20.6 %) and Internal Medicine wards (21.4 %). In a multivariable logistic regression, age (odds ratio [OR] 1.03, 95 % confidence interval [CI] 1.01-1.05), Activities of Daily Living dependence (OR 1.19, 95 % CI 1.12-1.27), dementia (OR 3.25, 95 % CI 2.41-4.38), malnutrition (OR 2.01, 95 % CI 1.29-3.14), and use of antipsychotics (OR 2.03, 95 % CI 1.45-2.82), feeding tubes (OR 2.51, 95 % CI 1.11-5.66), peripheral venous catheters (OR 1.41, 95 % CI 1.06-1.87), urinary catheters (OR 1.73, 95 % CI 1.30-2.29), and physical restraints (OR 1.84, 95 % CI 1.40-2.40) were associated with delirium. Admission to Neurology wards was also associated with delirium (OR 2.00, 95 % CI 1.29-3.14), while admission to other settings was not. Conclusions: Delirium occurred in more than one out of five patients in acute and rehabilitation hospital wards. Prevalence was highest in Neurology and lowest in Rehabilitation divisions. The "Delirium Day" project might become a useful method to assess delirium across hospital settings and a benchmarking platform for future surveys
The association of indwelling urinary catheter with delirium in hospitalized patients and nursing home residents: an explorative analysis from the "Delirium Day 2015"
No full textBackround: Use of indwelling urinary catheter (IUC) in older adults has negative consequences, including delirium.
Aim: This analysis, from the "Delirium Day 2015", a nationwide multicenter prevalence study, aim to evaluate the association of IUC with delirium in hospitalized and Nursing Homes (NHs) patients.
Methods: Patients underwent a comprehensive geriatric assessment, including the presence of IUC; inclusion criteria were age > 65 years, being Italian speaker and providing informed consent; exclusion criteria were coma, aphasia, end-of-life status. Delirium was assessed using the 4AT test (score ≥ 4: possible delirium; scores 1-3: possible cognitive impairment).
Results: Among 1867 hospitalized patients (mean age 82.0 ± 7.5 years, 58% female), 539 (28.9%) had IUC, 429 (22.9%) delirium and 675 (36.1%) cognitive impairment. IUC was significantly associated with cognitive impairment (OR 1.60, 95% CI 1.19-2.16) and delirium (2.45, 95% CI 1.73-3.47), this latter being significant also in the subset of patients without dementia (OR 2.28, 95% CI 1.52-3.43). Inattention and impaired alertness were also independently associated with IUC. Among 1454 NHs residents (mean age 84.4 ± 7.4 years, 70.% female), 63 (4.3%) had IUC, 535 (36.8%) a 4AT score ≥ 4, and 653 (44.9%) a 4AT score 1-3. The multivariate logistic regression analysis did not show a significant association between 4AT test or its specific items with IUC, neither in the subset of patients without dementia.
Discussion: We confirmed a significant association between IUC and delirium in hospitalized patients but not in NHs residents.
Conclusion: Environmental and clinical factors of acute setting might contribute to IUC-associated delirium occurrence
The instruments used by the Italian centres for cognitive disorders and dementia to diagnose mild cognitive impairment (MCI)
No full textAims: The purpose of this study was to examine the tools used in Italy to diagnose mild cognitive impairment (MCI). Methods: In collaboration with the Luigi Amaducci Research Consortium, the Italian Network of Alzheimer Evaluation Units prepared a questionnaire to describe how MCI is diagnosed in the Italian Centres for cognitive disorders and dementia (CCDD). Results: Most of the ninety-two CCDDs participating in the survey were located in hospitals (54.7%); large percentages were coordinated by neurologists (50.8%) and geriatricians (44.6%). Almost all (98.5%) used the Mini Mental State Examination to diagnose MCI; the Clock Drawing Test was also frequently used (83.9%). Other neuropsychological, imaging and biomarker tests were utilized less frequently and a wide diversity in the instruments used was noted. Conclusions: According to the results, diagnoses of MCI are based on a multitude of instruments, with major differences in the clinical assessment of geriatricians and neurologists. Standardized testing protocols, validated instruments and cut-off points need to be identified and adopted by the CCDDs for assessing MCI
Predictors of parenchymal hematoma and clinical outcome after mechanical thrombectomy in patients with large ischemic core due to large vessel occlusion: a retrospective multicenter study
No full textBackgroundThe aim of our study was to find predictors of parenchymal hematoma (PH) and clinical outcome after mechanical thrombectomy (MT) in patients with large vessel occlusion (LVO) and baseline large infarct.MethodsThe databases of 16 stroke centers were retrospectively screened for patients with anterior circulation LVO and baseline Alberta Stroke Program Early CT Score (ASPECTS) <= 5 that received MT. Procedural parameters, including the number of passes during first and second technique of MT, were recorded. Outcome measures were occurrence of PH type 2 and any type of PH after MT, and the 90-day modified Rankin Scale (mRS) score of 0-3 and 0-2.ResultsIn total, 408 patients were available for analysis. A higher number of passes in the second technique was predictive of PH type 2 (odds ratio (OR) - 3.204, 95% confidence interval (CI) 1.140 to 9.005), whereas procedure conducted under general anesthesia was associated with lower risk (OR 0.127, 95% CI 0.002 to 0.808). The modified thrombolysis in cerebral infarction grade 2c-3 was associated with the mRS score 0-3 (OR 3.373, 95% CI 1.891 to 6.017), whereas occurrence of PH type 2 was predictive of unfavorable outcome (OR 0.221, 95% CI 0.063 to 0.773). Similar results were found for the mRS score 0-2 outcome measure.ConclusionIn patients with large ischemic core, a higher number of passes during MT and procedure not conducted under general anesthesia are associated with increased rate of PH type 2, that negatively impact the clinical outcome. Our data outline a delicate balance between the need of a complete recanalization and the risk of PH following MT
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