51 research outputs found
Bodies of Clay on Prehistoric Humanised Pottery
No full textMarta Pestarino and Irò B. Camici review Heiner Schwarzberg and Valeska Becker (eds), Bodies of Clay on Prehistoric Humanised Pottery. Proceedings of the Session at the 19th EAA Annual Meeting at Pilsen, 5th September 2013, Philadelphia: Oxbow Books, 201
The nephrotic syndrome is an immunoinflammatory disorder
No full textAuthor shows that nephrotic syndrome is a complex immunoinflammatory disorde
Kidney disease and early detection
No full textAdversoutcomes of kidney disease can often prevented or delayed through early detection and treatment.The Author discuss about the question and about the guidelines of the K/DOQ
Renal Glomerular permselectivity and vascular endothelium
No full textThe Author discuss glomerular endothelium with particular emphasis on the barrire presumed to be impairted by andotheliumglomerular basement mebrane podocyte interactions
Systematic clinical management of patients with candidemia improves survival
No full textObjectives: Taking into account the significant morbidity, mortality, and hospital costs related to Candidemia, our objective is to define if improving appropriateness in candidemia management was associated with better clinical outcomes. Methods: A prospective observational monocentric cohort study was conducted. Adherence to five main elements was examined: appropriate selection of initial therapy; follow-up blood culture; echocardiography; ophthalmological examination; and removal of a central venous catheter. The correlation between the number of appropriate elements achieved and 30 day survival was examined. Results: Patients with candidemia (n = 213) were enrolled. Adherence to all five elements was achieved in 36 cases (16.9%), while the majority adhered to three or four elements (28.2% and 37.1%, respectively). Multivariable Cox regression analysis revealed that the number of elements achieved was associated with survival [HR: 0.39 (0.30–0.52); p < 0.001]. Also, the number of elements achieved correlated positively with duration of therapy (p = 0.01), but not length of hospital stay (p = 0.56). Conclusions: Five elements, including therapeutic and non-therapeutic-related aspects, of care were good indicators of appropriate management of patients with candidemia. Implementation of evidence-based practice regarding optimal clinical management is crucial for any antimicrobial stewardship program
Modeling the Effects Induced by the Expected Climatic Trends on Landslide Activity at Large Scale
No full textAbstractTraditionally, slope stability assessments are based on stationary expected extreme rainfalls, provided by the Intensity-Duration-Frequency curves. More recent approaches are based on projected rainfall scenarios, considering the expected climatic trends provided by General Circulation Models (GCMs). The projected rainfalls used in this study have been obtained by climate simulations from the Coupled Model Intercomparison Project Phase 5 (CMIP5). Different GCMs emission scenarios (Representative Concentration Pathways 2.6, 4.5, 8.5) and time horizons (e.g., 2010-2039; 2040-2069; 2070-2099) are analysed. In order to fill the scale gap between the spatial resolution of GCMs and the resolution required for impact studies, statistically downscaled climate projections provided by [1,2] are used as input into PG_TRIGRS [3] to predict the effect of climatic change on landslide activity. A hydrological basin located in the Umbria region of central Italy is used as case study
Validazione dei dati satellitari di precipitazione per la stima del deflusso nella parte medio-alta del bacino del Fiume Tevere tramite la modellistica semi distribuita in continuo.
No full textNell’ambito della Convenzione “contributo per la ricerca applicata nel settore dell’idrologia
operativa, in particolare degli strumenti in tempo reale di previsione e monitoraggio, anche in termini probabilistici, delle risorse idriche e del rischio idrogeologico (frane e alluvioni) a scala regionale” tra il CNR IRPI e il Centro Funzionale Decentrato della Regione Umbria (CFD) la tesi ha come obiettivo la stima della portata all’interno della parte medio-alta del bacino del Fiume Tevere, tramite l’utilizzo di un Modello Idrologico Semi distribuito in continuo (MISDc). Inoltre, è stata effettuata una valutazione della qualità dei dati satellitari di pioggia impiegati nello studio.
Il periodo di analisi è il quadriennio 2016-2019.
Il modello, sviluppato dall’Istituto di Ricerca Per la Protezione Idrogeologica di Perugia (CNR-IRPI), si compone di tre parti: la prima è un modulo di fusione nivale che discerne la
precipitazione totale in parte solida e liquida, la seconda è un modello di bilancio del suolo, che determina il contenuto d’acqua presente in esso in modo continuo e che definisce le condizioni iniziali per la terza parte: un modulo di trasferimento dell’onda di piena per la stima delle portate nelle diverse sezioni del bacino.
La zona che è stata oggetto di tale studio è la parte medio-alta del bacino del Fiume Tevere situata tra la diga di Montedoglio e la sezione di Monte Molino. Tale area presenta una superficie di circa 5200 km2.
All’interno o nelle immediate vicinanze del bacino del Fiume Tevere sono presenti 90 stazioni di monitoraggio pluviometrico, 77 stazioni di monitoraggio termometrico e 17 stazioni di monitoraggio idrometrico. Tali stazioni forniscono dati di pioggia, temperatura dell’aria e livello idrometrico con passo temporale semiorario per il periodo 2004-2020.
Nell’ottica di valutare il comportamento idrologico del bacino mediante la modellistica idrologica semi distribuita in continuo e, sulla base del reticolo idrografico IGM 1: 25.000, l’area di studio stata suddivisa in 98 elementi: 61 aree direttamente drenanti nell’asta fluviale di interesse e 37 bacini di testa.
I dati di input del modello sono: le precipitazioni e le temperature.
Oltre ad essere stati utilizzati i dati di pioggia e temperatura derivanti dalla rete pluviometrica regionale umbra e dalla rete pluviometrica globale (Global Precipitation Climatology Centre, GPCC), ho utilizzato i dati di pioggia provenienti da alcuni prodotti satellitari.
In particolare, ho acquisito i dati di pioggia attraverso tre prodotti derivanti dall’European
Organization for the Exploitation of Meteorological Satellites (EUMETSAT), un prodotto
proveniente dalla National Oceanic and Atmospheric Administration (NOAA) e, per ultimo, i
dati acquisiti dal prodotto proveniente dall’algoritmo “Soil Moisture to Rain” (SM2RAIN), sviluppato dall’Istituto di Ricerca per la Protezione Idrogeologica di Perugia, (CNR-IRPI) il quale stima la pioggia sulla base del contenuto d’acqua nel suolo.
Il modello MISDc, prima di essere stato utilizzato per stimare la portata, è stato calibrato e poi successivamente validato. La calibrazione è stata effettuata tramite la minimizzazione di una funzione obiettivo basata sull’indice di Kling-Gupta e ha riguardato solo alcune sezioni. La validazione è stata, successivamente, applicata alle sezioni rimanenti.
La valutazione per ciascuna sezione si è basata su tre indici di performance: l’indice KGE, l’indice di Nash-Sutcliffe (NS) e il coefficiente di determinazione (R).
Dai risultati che si ottengono attraverso l’applicazione del modello si evince un’ottima capacità di stima del deflusso tramite l’utilizzo della rete pluviometrica regionale con buoni valori degli indici di performance.
Inoltre, anche se con performance leggermente inferiori, l’utilizzo dei dati di pioggia derivanti dai prodotti satelliti ha evidenziano buoni risultati.
In particolare, per i dataset che integrano le informazioni derivanti dai satelliti e dai pluviometri si sono osservati i risultati migliori.
Nella seconda parte del lavoro è stata svolta un’analisi sulla qualità del dato di pioggia derivante dai prodotti satellitari. Tale valutazione si è basata sul confronto fra ciascun dataset satellitare con la rete pluviometrica regionale umbra utilizzando, anche in questo caso, tre indici di performance: l’indice di Kling-Gupta (KGE), il coefficiente di determinazione (R) e l’errore relativo quadratico medio (RRMSE).
I dataset satellitari mostrano una buona accuratezza nella stima del dato di pioggia rispetto al dato osservato.
In particolare, tra i prodotti satellitari che ho impiegato, la metodologia che ha presentato le performance migliori è quella relativa ai due prodotti integrati.
Tali prodotti si sono dimostrati essere i più efficienti sulla base di tutti e tre gli indici utilizzati
Contemporary survival trends and aetiological characterization in non-ischaemic dilated cardiomyopathy
No full textAim: Contemporary survival trends in dilated cardiomyopathy (DCM) are largely unknown. The aim of this study is to investigate clinical descriptors, survival trends and the prognostic impact of aetiological characterization in DCM patients.
Methods and results: Dilated cardiomyopathy patients were consecutively enrolled and divided into four groups according to the period of enrolment (1978-1984; 1985-1994; 1995-2004; and 2005-2015). A subset of patients with DCM of specific aetiology, enrolled from 2005 to 2015, was also analysed. Over a mean follow-up of 12 ± 8 years, 1284 DCM patients (52 in the 1978-1984 group, 326 in the 1985-1994 group, 379 in the 1995-2004 group, and 527 in the 2005-2015 group) were evaluated. Despite older age (mean age 51 ± 15, 43 ± 15, 45 ± 14, and 52 ± 15 years for the 1978-1984, 1985-1994, 1995-2004, and 2005-2015 groups, respectively; P < 0.001), most of the baseline clinical characteristics improved in the 2005-2015 group, suggesting a less advanced disease stage at diagnosis. Similarly, at competing risk analysis, the annual incidence of all outcome parameters progressively decreased over time (global P < 0.001). At multivariable analysis, the last period of enrolment emerged as independently associated with a reduction in all-cause mortality/heart transplantation (HTx)/ventricular assist device (VAD) implantation (1.46 events/100 patients/year), cardiovascular death/HTx/VAD implantation (0.82 events/100 patients/year) and sudden cardiac death (0.15 events/100 patients/year). Lastly, in 287 patients with DCM of specific aetiology, patients with environmental, toxic, or removable factors appeared to have different phenotypes and prognosis compared to those with genetic, post-myocarditis, or idiopathic DCM (P < 0.001).
Conclusions: Contemporary survival trends in DCM significantly improved, mainly due to a reduction of cardiovascular events. Appropriate aetiological characterization might help in prognostication of DCM patients
A 72-h intervention for improvement of the rate of optimal antibiotic therapy in patients with bloodstream infections
No full textAntimicrobial stewardship programs are implemented to optimize the use of antibiotics and control the spread of antibiotic resistance. Many antimicrobial stewardship interventions have demonstrated significant efficacy in reducing unnecessary prescriptions of antibiotics, the duration of antimicrobial therapy, and mortality. We evaluated the benefits of a combination of rapid diagnostic tests and an active re-evaluation of antibiotic therapy 72 h after the onset of bloodstream infection (BSI). All patients with BSI from November 2015 to November 2016 in a 1100-bed university hospital in Rome, where an Infectious Disease Consultancy Unit (Unità di Consulenza Infettivologica, UDCI) is available, were re-evaluated at the bedside 72 h after starting antimicrobial therapy and compared to two pre-intervention periods: the UDCI was called by the ward physician for patients with BSI and the UDCI was called directly by the microbiologist immediately after a pathogen was isolated from blood cultures. Recommendations for antibiotic de-escalation or discontinuation significantly increased (54%) from the two pre-intervention periods (32% and 27.2%, p < 0.0001). Appropriate escalation also significantly increased (22.5%) from the pre-intervention periods (8.1% and 8.2%, p < 0.0001). The total duration of antibiotic therapy decreased with intervention (from 21.9 days [standard deviation, SD 15.4] in period 1 to 19.3 days [SD 13.3] in period 2 to 17.7 days in period 3 [SD 11.5]; p = 0.002) and the length of stay was significantly shorter (from 29.7 days [SD 29.3] in period 1 to 26.8 days [SD 24.7] in period 2 to 24.2 days in period 3 [SD 20.7]; p = 0.04) than in the two pre-intervention periods. Mortality was similar among the study periods (31 patients died in period 1 (15.7%), 39 (16.7%) in period 2, and 48 (15.3%) in period 3; p = 0.90). Rapid diagnostic tests and 72 h re-evaluation of empirical therapy for BSI significantly correlated with an improved rate of optimal antibiotic therapy and decreased duration of antibiotic therapy and length of stay
Cognitive outcomes and psychological symptoms in an Italian cohort with post-acute COVID-19 condition (PACC)
No full textBackground: We aim to investigate the proportion of patients (pts) with long-term cognitive outcomes (CO) of PACC and identify associated features. Methods: We assessed participants through a neuropsychological assessment. The chi-square test was used for comparisons according with time of NPA (within or beyond 6 months since COVID19) and with previously hospitalization status (hospitalized patients, PH; not hospitalized patients, nPH). Results: 520 participants: mean age 54 years (SD 12), 53 % female, 14 years of education (SD 3.4), 35 % with >1 comorbidity, 48 % previously hospitalized. Overall, we found CO in 89 % of pts, in particular 88 % evaluated in w6M and 89 % in b6M (p = 0.801) while 90 % and 87 % in nPH and PH, respectively (p = 0.239). By fitting multivariable analysis, PH for COVID19 and female gender were associated with an increased risk of an altered PSQI [Odd Ratio, OR 2.48, 95 % CI 1.54 to 3.99, p < 0.001 and OR 2.59, 95 % CI 1.60 to 4.17, p < 0.001, respectively) and BAI [F vs M: OR 1.67, 95 % CI 1.16 to 2.40, p = 0.005). Conclusions: We show a substantial proportion of PACC-CO; hospitalization leads to impaired memory, anxiety and sleep disorders. Women seem to be at higher risk for anxious-depressive symptoms and worse sleep quality than men
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