29 research outputs found
Acute macular neuroretinopathy associated with subclinical cytomegalovirus infection
No full textTo report a case of bilateral acute macular neuroretinopathy (AMN) occurring in a 32-year-old woman, analyzed using the multimodal imaging technique
Interrater reliability of the Bayley III test in the Italian Northern-Adriatic Cohort II
No full textPirfenidone for Idiopathic Pulmonary Fibrosis and Beyond
No full textPirfenidone (PFD) slows the progression of idiopathic pulmonary fibrosis (IPF) by inhibiting the exaggerated fibrotic response and possibly through additional mechanisms, such as anti-inflammatory effects. PFD has also been evaluated in other fibrosing lung diseases. Myocardial fibrosis is a common feature of several heart diseases and the progressive deposition of extracellular matrix due to a persistent injury to cardiomyocytes may trigger a vicious cycle that leads to persistent structural and functional alterations of the myocardium. No primarily antifibrotic medications are used to treat patients with heart failure. There is some evidence that PFD has antifibrotic actions in various animal models of cardiac disease and a phase II trial on patients with heart failure and preserved ejection fraction has yielded positive results. This review summarises the evidence about the possible mechanisms of IPF and modulation by PFD, the main results about IPF or non-IPF interstitial pneumonias and also data about PFD as a potential protective cardiac drug
Evaluating the effectiveness of savings-fostering policies : the case of savings goal card in South Africa
No full textLAUREA MAGISTRALELa sostenibilità globale è un complesso equilibrio di diversi fattori e la crescente consapevolezza della sua importanza sta generando in quest’ambito un consistente aumento di studi e iniziative. In vista di questo macro obiettivo, una delle situazioni più dannose è la condizione di estrema povertà in cui versano larghe masse di popolazione. L’economia comportamentale si sta dimostrando un valido mezzo per studiare, mitigare e infine risolvere questo problema grazie al fatto che unisce l’approccio economico a quello psicologico. In questo modo è in grado di progettare strumenti specifici che insegnino alle fasce povere come gestire le proprie risorse economiche in maniera efficiente e sostenibile. In questo contesto, la nostra ricerca ha lo scopo di portare un contributo alla letteratura scientifica sulle abitudini di risparmio di questa porzione della popolazione. Questo, attraverso lo studio empirico di un programma di risparmio – il progetto “Goal Card” – progettato e implementato da una istituzione Sudafricana di microfinanza (SEF, the Small Enterprise Foundation).
Il nostro lavoro, iniziato con la revisione della letteratura esistente, ha previsto la creazione di un dataset originale tramite la raccolta di dati dagli archivi dell’istituzione e attraverso interviste con le partecipanti al programma e lo staff. Questi dati sono poi stati trattati con metodi statistici come la Difference-in-Difference. I risultati mostrano un impatto positivo del programma sui risparmi delle clienti, ma l’effetto rimane non del tutto in linea con le aspettative, in quanto variabili diverse mostrano andamenti contrastanti. Sulla base di questo esito, suggeriamo ulteriori studi che includano variabili e covariate aggiuntive. Inoltre, questi risultati ci portano a pensare che l’efficacia del programma sia da ricercare nel modo in cui le clienti usano i loro risparmi piuttosto che nel loro mero ammontare.Global sustainability is a complex equilibrium of a number of different factors and its fast-growing awareness is forcing an increasing number of specific studies and actions. In view of this final goal, one of the most detrimental situations is the poverty condition of large masses of population. Behavioural economics is a viable means to study, mitigate and ultimately solving this harmful condition as it merges psychological and economical approaches to design specific tools to teach people how to efficiently and sustainably manage their resources. In this perspective, the purpose of this research is to contribute to the scientific literature about savings among poor populations, by evaluating the effectiveness of a savings program – the Goal Card project – implemented by a South-African microfinance institution (SEF, the Small Enterprise Foundation).
Our work, after an initial review of the current literature, consisted in creating an original dataset by collecting data from SEF’s existing archives and through on-site interviews to the program’s participants and the staff. These data have then been selected and treated with different statistical techniques, such as Propensity Score Matching and Difference-in-Difference. The results show a positive impact of the program on the clients’ savings but the effect is not completely aligned with the project’s expectations, as different dependent variables show conflicting results. From the methodological point of view, we suggest further studies including additional covariates and variables for a more accurate analysis. Moreover, these outcomes bring us to believe that the effectiveness of this project is to be investigated in how the clients use their savings rather than the volume of the savings themselves
Quantitative CT Texture Analysis of COVID-19 Hospitalized Patients during 3–24-Month Follow-Up and Correlation with Functional Parameters
No full textBackground: To quantitatively evaluate CT lung abnormalities in COVID-19 survivors from the acute phase to 24-month follow-up. Quantitative CT features as predictors of abnormalities’ persistence were investigated. Methods: Patients who survived COVID-19 were retrospectively enrolled and underwent a chest CT at baseline (T0) and 3 months (T3) after discharge, with pulmonary function tests (PFTs). Patients with residual CT abnormalities repeated the CT at 12 (T12) and 24 (T24) months after discharge. A machine-learning-based software, CALIPER, calculated the CT percentage of the whole lung of normal parenchyma, ground glass (GG), reticulation (Ret), and vascular-related structures (VRSs). Differences (Δ) were calculated between time points. Receiver operating characteristic (ROC) curve analyses were performed to test the baseline parameters as predictors of functional impairment at T3 and of the persistence of CT abnormalities at T12. Results: The cohort included 128 patients at T0, 133 at T3, 61 at T12, and 34 at T24. The GG medians were 8.44%, 0.14%, 0.13% and 0.12% at T0, T3, T12 and T24. The Ret medians were 2.79% at T0 and 0.14% at the following time points. All Δ significantly differed from 0, except between T12 and T24. The GG and VRSs at T0 achieved AUCs of 0.73 as predictors of functional impairment, and area under the curves (AUCs) of 0.71 and 0.72 for the persistence of CT abnormalities at T12. Conclusions: CALIPER accurately quantified the CT changes up to the 24-month follow-up. Resolution mostly occurred at T3, and Ret persisting at T12 was almost unchanged at T24. The baseline parameters were good predictors of functional impairment at T3 and of abnormalities’ persistence at T12
COVID-19 pulmonary phenotypes and longitudinal patterns in the first wave of the pandemic
No full textBackground: The long-term evolution of COVID-19 in patients hospitalized during the pandemic's first wave remains largely unexplored. This study aimed to identify COVID-19 pulmonary phenotypes and their longitudinal patterns over a 12-month follow-up. Methods: COVID-19 patients discharged from Pisa University Hospital (Italy) between March–September 2020, were evaluated at T3, T12, and T24 months post-discharge. Assessments included spirometry, lung volumes, DLCO, and chest CT for those with persistent pneumonia signs (PS). Latent transition analysis (LTA) identified COVID-19 phenotypes and longitudinal patterns based on PS and lung function (PFTs). Risk factors for these patterns were evaluated using multinomial logistic regression. Results: Of 307 discharged patients, 175, 136, and 33 were followed-up at T3, T12, and T24, respectively. At T12, 21.6 % had impaired DLCO, 4.4 % a restrictive ventilatory pattern, and 31,6 % still had PS, persisting until T24. LTA identified three cross-sectional phenotypes at both T3 and T12 (no PS with normal PFTs; PS with normal PFTs; PS with impaired PFTs), and four longitudinal patterns from T3 to T12: persistence of no PS with normal PFTs (47.9 %); resolution of both PS and PFTs (15.4 %); persistent PS (36.7 %), either with (11 %) or without (25.7 %) impaired PFTs. The last two patterns correlated significantly with longer hospitalization, more comorbidities, and severe COVID-19. Conclusions: In our cohort of COVID-19 patients hospitalized during the pandemic's first wave, we observed distinct pulmonary phenotypes and longitudinal recovery patterns. More comorbidities and severe acute disease correlated with worse progression up to 24 months, suggesting long-term monitoring for such patients
PO-0389 Outcome Of Very Preterm Children At School Age: Results From The Area-based Italian Action Follow-up Study
No full textSilent brain ischemia within the TAXINOMISIS framework: association with clinical and advanced ultrasound metrics
No full textCarotid ultrasound; Computational fluid dynamics; Silent brain infarctsEcografía carotídea; Dinámica de fluidos computacional; Infartos cerebrales silenciososEcografia caròtida; Dinàmica de fluids computacional; Infarts cerebrals silenciososIntroduction: The relationship between carotid artery stenosis (CAS) and ipsilateral silent brain ischemia (SBI) remains unclear, with uncertain therapeutic implications. The present study, part of the TAXINOMISIS project (nr. 755,320), aimed to investigate SBIs in patients with asymptomatic CAS, correlating them with clinical, carotid ultrasonographic data, and CFD analyses.
Methods: The TAXINOMISIS clinical trial study (nr. NCT03495830) involved six vascular surgery centers across Europe, enrolling patients with asymptomatic and symptomatic CAS ranging from 50 to 99%. Patients underwent carotid ultrasound and magnetic resonance imaging (MRI), including brain diffusion-weighted, T2-weighted/FLAIR, and T1-weighted sequences. Brain MRI scans were analyzed for the presence of SBI according to established definitions. Ultrasound assessments included Doppler and CFD analysis. Only asymptomatic patients were included in this substudy.
Results: Among 195 asymptomatic patients, the mean stenosis (NASCET) was 64.1%. Of these, a total of 33 patients (16.9%) had at least one SBI detected on a brain MRI scan. Specifically, 19 out of 33 patients (57.6%) had cortical infarcts, 4 out of 33 patients (12.1%) had ipsilateral lacunar infarcts, 6 out of 33 patients had (18.2%) subcortical infarcts, 1 out of 33 patients (3.0%) had both cortical and lacunar infarcts, and 3 out of 33 patients (9.1%) both cortical and subcortical infarcts. Patients with SBIs exhibited significantly higher risk factors, including a higher body mass index (28.52 ± 9.38 vs. 26.39 ± 3.35, p = 0.02), diastolic blood pressure (80.87 ± 15.73 mmHg vs. 80.06 ± 8.49 mmHg, p = 0.02), creatinine levels (93.66 ± 34.61 μmol/L vs. 84.69 ± 23.67 μmol/L, p = 0.02), and blood triglycerides (1.8 ± 1.06 mmol/L vs. 1.48 ± 0.78 mmol/L, p = 0.03). They also had a higher prevalence of cardiovascular interventions (29.6% vs. 13.8%, p = 0.04), greater usage of third/fourth-line antihypertensive treatment (50%vs16%, p = 0.03), and anticoagulant medications (60% vs. 16%, p = 0.01). Additionally, the number of contralateral cerebral infarcts was higher in patients with SBIs (35.5% vs. 13.4%, p < 0.01). Moreover, carotid ultrasound revealed higher Saint Mary’s ratios (15.33 ± 12.45 vs. 12.96 ± 7.99, p = 0.02), and CFD analysis demonstrated larger areas of low wall shear stress (WSS) (0.0004 ± 0.0004 m2 vs. 0.0002 ± 0.0002 m2, p < 0.01).
Conclusion: The TAXINOMISIS clinical trial provides valuable insights into the prevalence and risk factors associated with SBIs in patients with moderate asymptomatic carotid stenosis. The findings suggest that specific hemodynamic and arterial wall characteristics may contribute to the development of silent brain infarcts.The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This study received funding from the European Union’s Horizon 2020 research and innovation program under grant agreement nr. 755320
The descriptive epidemiology of melanoma in Italy has changed - for the better
No full text: A recent research project using data from a total of 40 cancer registries has provided new epidemiologic insights into the results of efforts for melanoma control in Italy between the 1990s and the last decade. In this article, the authors present a summary and a commentary of their findings. Incidence increased significantly throughout the study period in both sexes. However, the rates showed a stabilization or a decrease in men and women aged below 35 years. The risk of disease increased for successive cohorts born until 1973 (women) and 1975 (men) while subsequently tending to decline. The trend towards decreasing tumor thickness and increasing survival has continued, but a novel favorable prognostic factor has emerged since 2013 for patients - particularly for males - with thick melanoma, most likely represented by molecular targeted therapies and immune checkpoint inhibitors. Due to this, the survival gap between males and females has been filled out. In the meanwhile, and despite the incidence increase, dermatologists have not lowered their threshold to perform skin biopsy. Skin biopsy rate has increased because of the increasingly greater volume of dermatologic office visits, but the proportion of skin biopsies out of dermatologic office visits has remained constant. In summary, an important breakthrough in melanoma control in Italy has taken place. Effective interventions have been implemented across the full scope of care, which involve many large local populations - virtually the whole national population. The strategies adopted during the last three decades represent a valuable basis for further steps ahead in melanoma control in Italy
A randomized placebo-controlled trial of varenicline for smoking cessation allowing flexible quit dates
No full textIntroduction: Current smoking cessation guidelines recommend setting a quit date prior to starting pharmacotherapy. However, providing flexibility in the date of quitting may be more acceptable to some smokers. The objective of this study was to compare varenicline 1 mg twice daily (b.i.d.) with placebo in subjects using a flexible quit date paradigm after starting medication. Methods: In this double-blind, randomized, placebo-controlled international study, smokers of ≥10 cigarettes/day, aged 18-75 years, and who were motivated to quit were randomized (3:1) to receive varenicline 1 mg b.i.d. or placebo for 12 weeks. Subjects were followed up through Week 24. Subjects were instructed to quit between Days 8 and 35 after starting medication. The primary endpoint was carbon monoxide-confirmed continuous abstinence during Weeks 9-12, and a key secondary endpoint was continuous abstinence during Weeks 9-24. Results: Overall, 493 subjects were randomized to varenicline and 166 to placebo. Continuous abstinence was higher for varenicline than for placebo subjects at the end of treatment (Weeks 9-12: 53.1% vs. 19.3%; odds ratio [OR] 5.9; 95% CI, 3.7-9.4; p < .0001) and through 24 weeks follow-up (Weeks 9-24: 34.7% vs. 12.7%; OR 4.4; 95% CI, 2.6-7.5; p < .0001). Serious adverse events occurred in 1.2% varenicline (none were psychiatric) and 0.6% placebo subjects. Fewer varenicline than placebo subjects reported depression-related adverse events (2.3% vs. 6.7%, respectively). Conclusions: Varenicline 1 mg b.i.d. using a flexible quit date paradigm had similar efficacy and safety compared with previous fixed quit date studies. © The Author 2011. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco
