Assessing the heterogeneity of the impact of COVID-19 incidence on all-cause excess mortality among healthcare districts in Lombardy, Italy, to evaluate the local response to the pandemic: an ecological study.

Objectives: The fragmentation of the response to the COVID-19 pandemic at national, regional and local levels is a possible source of variability in the impact of the pandemic on society. This study aims to assess how much of this variability affected the burden of COVID-19, measured in terms of all-cause 2020 excess mortality.

Design: Ecological retrospective study.

Strategies to convert hospital beds for COVID-19 patients to minimize emergency department overcrowding.

The shortage of hospital beds for COVID-19 patients has been one critical cause of Emergency Department (ED) overcrowding. We aimed at elaborating a strategy of conversion of hospital beds, from non-COVID-19 to COVID-19 care, minimizing both ED overcrowding and the number of beds eventually converted. Observational retrospective study.

Detection of patients with COVID-19 by the emergency medical services in Lombardy through an operator-based interview and machine learning models.

Background: The regional emergency medical service (EMS) in Lombardy (Italy) developed clinical algorithms based on operator-based interviews to detect patients with COVID-19 and refer them to the most appropriate hospitals. Machine learning (ML)-based models using additional clinical and geospatial epidemiological data may improve the identification of infected patients and guide EMS in detecting COVID-19 cases before confirmation with SARS-CoV-2 reverse transcriptase PCR (rtPCR).

Methods: This was an observational, retrospective cohort study using data from October 2020 to July 2021 (training set) and October 2021 to December 2021 (validation set) from patients who underwent a SARS-CoV-2 rtPCR test within 7 days of an EMS call.

Business Intelligence applied to Emergency Medical Services in the Lombardy region during SARS-CoV-2 epidemic.

Background And Aim Of The Work: On the 21st of February, the first patient was tested positive for SARS-CoV-2 at Codogno hospital in the Lombardy region. From that date, the Regional Emergency Medical Services (EMS) Trust (AREU) of the Lombardy region decided to apply Business Intelligence (BI) to the management of EMS during the epidemic. The aim of the study is to assess in this context the impact of BI on EMS management outcomes.

Out-of-hospital cardiac arrest (OHCA) Survey in Lombardy: data analysis through prospective short time period assessment.

Background And Aim Of The Work: The results of out-of-hospital cardiac arrests (OHCA) are usually reported through data collected collected via "ad hoc"  registries, but in large populations, samples of short time periods can be used to apply the results to the entire population. We would like to describe the situation of Lombardy to provide evidence on successful procedures, which may be carried out in a larger context.

Methods: Observational, prospective, analytical, single cohort study in Lombardy population.

Emergency department performances during overcrowding: the experience of the health protection agency of Brianza.

Hospital emergency departments (ED) can contribute to improve health outcomes and reduce costs of health care system. This study evaluated ED admissions during a twelve months period, analyzing characteristics of patients who underwent to emergency care in order to understand factors involved in ED overcrowding and promote adequate management. This retrospective study analyzed a twelve months window, with in-depth focus on December/January when almost all EDs reported overcrowding.

Amplitude spectrum area to guide defibrillation: a validation on 1617 patients with ventricular fibrillation.

Background: This study sought to validate the ability of amplitude spectrum area (AMSA) to predict defibrillation success and long-term survival in a large population of out-of-hospital cardiac arrests.

Methods And Results: ECGs recorded by automated external defibrillators from different manufacturers were obtained from patients with cardiac arrests occurring in 8 city areas. A database, including 2447 defibrillations from 1050 patients, was used as the derivation group, and an additional database, including 1381 defibrillations from 567 patients, served as validation.

[The epidemiologic surveillance of malignant mesothelioma in the Lower Iseo Lake area].

Starting from an hospital observation of the mesotheliomas cluster in women living in a lakeside area (Iseo lake, Northern Italy), an epidemiological surveillance of this tumour was performed by the local occupational health service. This cluster wasn't notified, in spite of the relevant number of factories producing asbestos textile materials in this area. From 1977 to august 2006, 45 cases of mesothelioma were detected among the workers of 3 textile industries located in 3 little villages: 14 cases occurred working crocidolite and chrysotile rope and gasket; 20 cases in a textile factory producing cotton garments, that was adjacent to and polluted by the farmer and were asbestos insulation and blankets used for fireproofing are present; 11 cases occurred among women working in silk factories.

A novel prognostic index to determine the impact of cardiac conditions and co-morbidities on one-year outcome in patients with heart failure.

Prognostic stratification is relevant in clinical decision making in heart failure (HF). Predictors identified during hospitalization or in clinical trials may be unrepresentative of HF in the community. The aim of this study was to derive and validate, in different clinical settings, a risk stratification model for the prediction of stable HF outcomes.

[Cardiovascular medicine unit: preliminary results of an in-hospital multidisciplinary intervention in heart failure].

Background: In Italy the majority of patients with heart failure are admitted to Internal Medicine Divisions, where diagnostic and therapeutic procedures, suggested by guidelines, are less utilized than in Cardiology Divisions. In order to provide a better assistance to patients with heart failure, a Cardiovascular Medicine Unit was founded with interdepartmental valence (Cardiovascular and Internal Medicine) in the "Ospedali Riuniti" Hospital of Bergamo. The purpose of this study was to evaluate the preliminary results, concerning management of heart failure, in the first 6 months of activities carried out at the Cardiovascular Medicine Unit and to compare them with those of other structures that usually manage this disease.