Positron emission tomography (PET) combined with computed tomography (CT) is an established diagnostic modality that has become an essential imaging tool in oncological practice. However, thanks to ...its noninvasive nature and its capability to provide physiological information, the main applications of this technique have significantly expanded.(18)F-labelled fluorodeoxyglucose (FDG) is the most commonly used radiopharmaceutical for PET scanning and demonstrates metabolic activity in various tissues. Since activated inflammatory cells, like malignant cells, predominantly metabolise glucose as a source of energy and increase expression of glucose transporters when activated, FDG-PET/CT can be successfully used to detect and monitor a variety of lung diseases, such as infections and several inflammatory conditions.The added value of FDG-PET/CT as a molecular imaging technique relies on its capability to identify disease in very early stages, long before the appearance of structural changes detectable by conventional imaging. Furthermore, by detecting the active phase of infectious or inflammatory processes, disease progression and treatment efficacy can be monitored.This review will focus on the clinical use of FDG-PET/CT in nonmalignant pulmonary diseases.
The depositional and erosional history of the Lapis Tiburtinus endogenic travertine located circa 25 km to the east of Rome, Central Italy, near the Colli Albani quiescent volcano, is interpreted ...through three-dimensional stratigraphy and uranium-series geochronology. Analyses of large exposures located in active quarries and of cores obtained from 114 industrial wells reveal that the travertine deposit is about 20 km
2 wide and 60 m thick on average. The travertine thickness is over 85 m toward its western N–S-elongated side, where thermal springs and large sinkholes occur aligned over a seismically-active N-striking fault. The travertine age was calculated using the U/Th isochron method. Results constrain the onset and conclusion of travertine deposition at about 115 and 30 ka, respectively. The three-dimensional study of the travertine shows that this deposit is characterized by a succession of depositional benches grown in an aggradational fashion. The benches are separated by five main erosional surfaces, which are associated with paleosols, conglomerates, and karstic features. This evidence shows that the travertine evolution was mostly controlled by water table fluctuations. Chronological correlations between travertine evolution and paleoclimate indicators suggest that the travertine deposition was partly modulated by climate conditions. Other influencing factors may have been fault-related deformation and volcanic events.
Quantitative assessments of the relationship between health and medical treatment are of great importance to policy makers. To overcome endogeneity problems we formulate and estimate a tractable ...dynamic factor model where observed health outcomes are driven by the individual's latent health. The dynamics of latent health reflects both exogenous health deterioration and endogenous health investments. Our model allows us to investigate the effect of medical treatment on current health, as well as on future medical treatment and health outcomes. We estimate the model by maximum simulated likelihood and minimum distance methods using a rich longitudinal data set from Italy obtained by merging a number of administrative archives. These data contain detailed information on medical drug purchase, hospitalization, and mortality for a representative sample of elderly hypertensive patients. Our findings show that the observed autocorrelation in medical treatment reflects both permanent and time‐varying observed and unobserved heterogeneity. They also show that medical drug purchase significantly maintains future health levels and prevents transitions to worse health. This suggests that policies aimed at increasing the awareness and the compliance of hypertensive patients help reduce cardiovascular risks and consequent hospitalization and mortality.
The aim of the study was to investigate the role of chronic kidney disease (CKD) on in-hospital mortality and on incident atrial fibrillation (AF) in patients infected with SARS-CoV-2. The incidence ...of acute kidney injury (AKI) was also investigated. Multivariable regression models were used to assess the association between renal function groups (estimated Glomerular Filtration Rate, eGFR, >60 mL/min, 30–59 mL/min, <30 mL/min) and in-hospital all-cause mortality and incident AF and AKI. A cohort of 2816 patients admitted in one year for COVID-19 disease in two large hospitals was analyzed. The independent predictors of mortality were severe CKD HR 1.732 (95%CI 1.264–2.373), older age HR 1.054 (95%CI 1.044–1.065), cerebrovascular disease HR 1.335 (95%CI (1.016–1.754), lower platelet count HR 0.997 (95%CI 0.996–0.999), higher C-reactive protein HR 1.047 (95%CI 1.035–1.058), and higher plasma potassium value 1.374 (95%CI 1.139–1.658). When incident AKI was added to the final survival model, it was associated with higher mortality HR 2.202 (1.728–2.807). Incident AF was more frequent in patients with CKD, but in the multivariable model only older age was significantly related with a higher incidence of AF OR 1.036 (95%CI 1.022–1.050). Incident AF was strongly associated with the onset of AKI HR 2.619 (95%CI 1.711–4.009). In this large population of COVID-19 patients, the presence of severe CKD was an independent predictor of in-hospital mortality. In addition, patients who underwent AKI during hospitalization had a doubled risk of death. Incident AF became more frequent as eGFR decreased and it was significantly associated with the onset of AKI.
(1) Background: Among the different cardiovascular (CV) manifestations of the coronavirus disease 2019 (COVID-19), arrhythmia and atrial fibrillation (AF) in particular have recently received special ...attention. The aims of our study were to estimate the incidence of AF in patients hospitalized for COVID-19, and to evaluate its role as a possible predictor of in-hospital all-cause mortality. (2) Methods: We enrolled 3435 people with SARS-CoV2 infection admitted to three hospitals in Northern Italy from February 2020 to May 2021. We collected data on their clinical history, laboratory tests, pharmacological treatment and intensive care unit (ICU) admission. Incident AF and all-cause in-hospital mortality were considered as outcomes. (3) Results: 145 (4.2%) patients developed AF during hospitalization, with a median time since admission of 3 days (I-III quartile: 0, 12). Patients with incident AF were admitted more frequently to the ICU (39.3 vs. 12.4%, p < 0.001), and more frequently died (37.2 vs. 16.9%, p < 0.001). In the Cox regression model, the significant determinants of incident AF were age (HR: 1.041; 95% CI: 1.022, 1.060 per year), a history of AF (HR: 2.720; 95% CI: 1.508, 4.907), lymphocyte count (HR: 0.584; 95% CI: 0.384, 0.888 per 103/µL), estimated glomerular filtration rate (eGFR, HR: 0.988; 95% CI: 0.980, 0.996 per mL/min) and ICU admission (HR: 5.311; 95% CI: 3.397, 8.302). Incident AF was a predictor of all-cause mortality (HR: 1.405; 95% CI: 1.027, 1.992) along with age (HR: 1.057; 95% CI: 1.047, 1.067), male gender (HR: 1.315; 95% CI: 1.064; 1.626), dementia (HR: 1.373; 95% CI: 1.045, 1.803), lower platelet (HR: 0.997; 95% CI: 0.996, 0.998 per 103/µL) and lymphocyte counts (HR: 0.843; 95% CI: 0.725, 0.982 per 103/µL), C-Reactive protein values (HR: 1.004; 95% CI: 1.003, 1.005 per mg/L), eGFR (HR: 0.990; 95% CI: 0.986, 0.994 per mL/min), and ICU admission (HR: 1.759; 95% CI: 1.292, 2.395). (4) Conclusions: Incident AF is a common complication in COVID-19 patients during hospitalization, and its occurrence strongly predicts in-hospital mortality.
The most common arrhythmia associated with COronaVIrus-related Disease (COVID) infection is sinus tachycardia. It is not known if high Heart Rate (HR) in COVID is simply a marker of higher systemic ...response to sepsis or if its persistence could be related to a long-term autonomic dysfunction. The aim of our work is to assess the prevalence of elevated HR at discharge in patients hospitalized for COVID-19 and to evaluate the variables associated with it. We enrolled 697 cases of SARS-CoV2 infection admitted in our hospital after February 21 and discharged within 23 July 2020. We collected data on clinical history, vital signs, laboratory tests and pharmacological treatment. Severe disease was defined as the need for Intensive Care Unit (ICU) admission and/or mechanical ventilation. Median age was 59 years (first-third quartile 49, 74), and male was the prevalent gender (60.1%). 84.6% of the subjects showed a SARS-CoV-2 related pneumonia, and 13.2% resulted in a severe disease. Mean HR at admission was 90 ± 18 bpm with a mean decrease of 10 bpm to discharge. Only 5.5% of subjects presented HR > 100 bpm at discharge. Significant predictors of discharge HR at multiple linear model were admission HR (mean increase = β = 0.17 per bpm, 95% CI 0.11; 0.22, p < 0.001), haemoglobin (β = −0.64 per g/dL, 95% CI −1.19; −0.09, p = 0.023) and severe disease (β = 8.42, 95% CI 5.39; 11.45, p < 0.001). High HR at discharge in COVID-19 patients is not such a frequent consequence, but when it occurs it seems strongly related to a severe course of the disease.
Although surveys routinely ask respondents to evaluate various aspects of their life on an ordered scale, there is concern about interpersonal comparability of these selfassessments. Statistically, ...the problem is one of identification in ordered response models with heterogeneous thresholds. As a solution to the identification problem, King and his colleagues proposed the use of anchoring vignettes, namely brief descriptions of hypothetical people or situations that survey respondents are asked to evaluate on the same scale as they use to rate their own situation. Although vignettes have been introduced in several social surveys and are increasingly employed in a variety of fields, the reliability of this approach hinges crucially on the validity of the assumptions of response consistency and vignette equivalence. The paper proposes a joint test of these key assumptions based on the fact that the underlying statistical model is overidentified if the two assumptions hold. Monte Carlo results show that the test proposed has good size and power properties in finite samples. We apply our test to selfassessment of pain by using data from the first wave of the Survey of Health, Ageing and Retirement in Europe. We find that, when using only one of the three available vignettes, or when the test is carried out separately by subgroups of respondents, the overidentifying restrictions are less likely to be rejected.
► We examine the main drivers of teacher mobility. ► We focus on teachers’ desired mobility by using applications-to-transfer data. ► The teachers’ place of birth is important in explaining teacher ...mobility. ► Disadvantaged and minority students frequently end up with less experienced teachers.
Of particular importance for education policy-makers is the possibility that teacher mobility adversely affects the quality of teaching in schools serving mainly disadvantaged and minority children. This paper examines the main drivers of the mobility of Italian teachers by using applications-to-transfer data. We find that teachers systematically try to move away from schools where teaching is likely to be more difficult because of the student mix or the social context of the school. Given the absence of any criteria other than seniority in regulating teachers’ allocation across schools, disadvantaged students frequently end up with less experienced teachers who are often just waiting to move elsewhere.
Elderly Hodgkin lymphoma (HL) is an aggressive lymphoma subgroup with high 18F-FDG avidity at 18F-FDG-PET/CT but no shared criteria for PET/CT in treatment evaluation and prediction of outcome are ...available. The aim of our bicentric study was to investigate whether the metabolic baseline PET/CT parameters can predict treatment response and prognosis in elderly HL. We retrospectively included 123 patients who underwent baseline 18F-FDG-PET/CT and end of treatment PET/CT scans. The PET images were analyzed visually and semi-quantitatively by measuring the lesion to liver SUVmax ratio (L-L SUV R), lesion to blood-pool SUVmax ratio (L-BP SUV R), metabolic tumor volume (MTV), and total lesion glycolysis (TLG). Survival curves were plotted according to the Kaplan-Meier method. At a median follow-up of 40 months, the median PFS and OS were 29 and 37 months. L-BP SUV R, L-L SUV R, MTV, and TLG were significantly higher in patients with no complete response compared with complete response group at end of treatment. Moreover, these parameters were demonstrated to be independent prognostic factors for PFS together with tumor stage, while only L-L SUV R and L-BP SUV R for OS. End of treatment PET/CT results using Deauville criteria were significantly correlated with outcome survival. End of treatment PET/CT results (using Deauville criteria) and semiquantitative baseline PET/CT parameters were significantly correlated with response to treatment and long-term outcome.
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