1,721,058 research outputs found
Particolato atmosferico e salute pubblica: studio dell’impatto sul sistema respiratorio attraverso ricoveri e consumo farmacologico
No full textCase-only analysis of interaction between pre-hospitalization respiratory treatments and pm10 exposure. Results from administrative databases
No full textBackground and Aims: While many studies have reported associations of air pollution with hospital admissions, little is known about whether pre-event medical treatments modify those associations. Our study analyzed how pre-admission respiratory pharmacological treatments affect the relationship between PM10 and hospitalizations for respiratory diseases.
Methods: Hospital admissions for respiratory causes (ICD-9-CM 460-466, 480-487, 491, 493, 5130 and 5188) during 2005 in the residents of six cities of Lombardy (Northern Italy), accounting for roughly 500.000 inhabitants, were selected. For each hospitalized subject we determined which respiratory treatment he/she was undergoing, using record linkage with pre-hospitalization medical prescriptions for respiratory drugs. Daily average concentration of PM10 and temperature were provided by the Regional Agency for Environmental Protection of Lombardy. We used a case-only approach to analyze the modification of the effect of PM10 on respiratory hospital admissions due to medical treatments. Separate models were fitted for systemic glucocorticoids, inhaled adrenergics, inhaled glucocorticoids, inhaled anticholinergics and theophylline. The models accounted for the simultaneous presence of different classes of respiratory treatments, long and short term confounding, heterogeneity among cities and effect of temperature.
Results: We selected 4,248 hospital admissions with a respiratory diagnosis and 7,717 respiratory prescriptions, related to 3,604 subjects. Pre-admission respiratory therapy was present in 39% of the admissions. The observed modification of the effect of PM10 on respiratory hospitalizations was modest for all of the examined treatments. We observed a significant effect modification (results shown for a 10 μg/m3 increment in PM10 concentration) associated with the use of systemic glucocorticoids before the hospitalization (OR=0.929, 95% CI, 0.892 – 0.967), which persists during the cold season (OR=0.927, CI 95% 0.881 – 0.976).
Conclusions: This pilot study, conducted on a reduced sample of the Northern Italian population, shows interesting evidences of a potential protective effect of systemic glucocorticoids against adverse respiratory consequences of exposure to PM10
iMPACT OF CARDIAC RESYNCHRONISATION THERAPY WITH DEFIBRILLATION BACK-UP IMPLANTATION ON CLINICAL OUTCOMES AND HEALTCARE RESOURCE UTILISATION: AN ITALIAN COHORT STUDY
No full textPM10 e ricoveri cardiorespiratori in sei comuni lombardi
No full textAim – This study was built in order to investigate the effect of particulate matter (PM10) on cardiovascular and respiratory systems, through the analysis of hospital admissions occurred in six cities in Lombardy Region during year 2005, for pathologies affecting the aforementioned systems.
Materials and methods – Cardiovascular and respiratory events were selected from the regional database of hospital discharge. ARPA Lombardy provided data about daily average of PM10 concentration, temperature and relative humidity. We used a generalized additive model to estimate the relationship between the daily frequency of admission per 100.000 residents and the pollutant concentration. We also evaluated the effect modifications due to sex and age.
Results – We selected 13.207 admissions, mainly for cardiovascular events. The analysis highlighted an increase in the frequency of respiratory admissions in correspondence with high PM10 concentration. The effect was stronger on young women throughout the year and on elderly people, especially in the warm season. There was evidence for an increase in the frequency of cardiovascular admissions in days with high PM10 concentration during the warm season.
Discussion – Results suggest that high concentrations of PM10 may have negative effects on the respiratory and cardiovascular systems, especially when associated with warm and humid weather conditions
Granulocyte colony-stimulating factor for stem cell mobilisation in acute myocardial infarction: a randomised controlled trial
No full textBackground To determine whether granulocyte colony-stimulating factor (G-CSF) improves clinical outcomes after large ST-elevation myocardial infarction (STEMI) when administered early in patients with left ventricular (LV) dysfunction after successful percutaneous coronary intervention (PCI). Methods STEM-AMI OUTCOME was designed as a prospective, multicentre, nationwide, randomised, open-label, phase III trial (ClinicalTrials.gov ID: NCT01969890) to demonstrate the efficacy and safety of early G-CSF administration in reducing 2-year cardiac mortality and morbidity in patients with STEMI with LV ejection fraction ≤45% after PCI. The primary outcome was a composite of all-cause death, recurrence of myocardial infarction and hospitalisation for heart failure. Due to low recruitment and event rates, the study was discontinued and did not achieve adequate statistical power to verify the hypothesis. Results Patients were randomly allocated to G-CSF (n=260) or standard of care (SOC; n=261). No difference was found in the composite primary outcome between study groups (HR 1.20; 95% CI 0.63 to 2.28). The 2-year mortality was 2.31% in the G-CSF and 2.68% in the control group (HR 0.88; 95% CI 0.29 to 2.60). Adverse events did not differ between the G-CSF (n=65) and SOC groups (n=58; OR 1.17; 95% CI 0.78 to 1.75). In post hoc analyses on the intervention group, we observed a trend towards fewer composite primary outcomes in patients with low bone marrow (BM) cell mobilisation (n=108) versus those with high mobilisation (n=152, with peak leucocyte count >50×109/L; HR 2.86; 95% CI 0.96 to 8.56). Primary outcomes were lower in patients with severe LV systolic dysfunction at discharge treated with G-CSF than in controls (interaction β±SE, −0.08±0.04; p=0.034). Conclusions Although inconclusive, this is the largest trial in the field of cell-based cardiac repair after STEMI providing evidence of the tolerability and long-term safety of G-CSF treatment. The results prompt further studies to understand which patient can benefit most from BM cell mobilisation
La valutazione epidemiologica degli indicatori socio-biologici di stress-lavoro-correlato: primi risultati del progetto della Regione Lombardia “stress ed attività lavorativa”
No full textDo statins mitigate the effects of pm10? a case-only analysis on hospital admissions from regional government administrative databases
No full textBackground and Aims: While particles are associated with hospital admissions for heart disease, there is little evidence about the role of pre-admission medication. Our aim was to investigate how pre-admission cardiovascular treatment modifies the effect of PM10 on hospitalization for cardiovascular diseases.
Methods: We examined cardiovascular hospital admissions (ICD-9-CM 410 – 429) occurred during 2005 in the residents of six cities of Lombardy (Northern Italy), accounting for roughly 500.000 inhabitants. For each inpatient we obtained his/her pre-hospitalization medical prescriptions of cardiovascular drugs. Daily average concentration of PM10 and temperature were provided by the Regional Agency for Environmental Protection of Lombardy. The modification of the effect of PM10 exposure on hospital admissions for cardiovascular diseases due to medical treatment was assessed through a case-only approach. We fitted separate models for statins, antiarrythimcs, and all other cardiovascular drugs, accounting for the simultaneous presence of more than one among the three aforementioned classes of drug, long and short term confounding, heterogeneity among cities and effect of temperature.
Results: During the study, 8,527 hospital admissions with cardiovascular diagnosis occurred to 6,467 subjects. Cardiovascular prescriptions related to patients hospitalized for cardiovascular causes were 52,205. 76.83% of the admitted patients had a pre-hospitalization cardiovascular therapy. The results of case-only analyses showed a significant modification of PM10 effect for all the examined active agents. The strongest effect modification was due to pre-admission treatment with lipid modifying agents (OR treated vs non treated, related to a 10 μg/m3 increment in PM10 concentration: 0.967, 95% CI, 0.945 – 0.989). The trend observed for the whole year was confirmed both in warm and cold season, though the results were not statistically significant after stratification for season.
Conclusions: Our study gives some interesting indications of cardiovascular treatments, and in particular statins, having a protective effect against the negative consequences of exposure to PM10
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
- …
