Effect of a food supplement containing berberine, monacolin K, hydroxytyrosol and coenzyme Q on lipid levels: a randomized, double-blind, placebo controlled study.

Purpose: To evaluate the ability of the new food supplement, Body Lipid (BL), containing red yeast rice, berberine, coenzyme Q and hydroxytyrosol, to lower the LDL-C in patients with mild-to-moderate hypercholesterolemia and to assess the overall safety profile of the product.

Methods: In this multicenter, randomized, double-blind, placebo and active comparator (the marketed Armolipid Plus [AM]) controlled study, 158 hypercholesterolemic patients were randomized following a 4-week dietary run-in period. After 4 weeks of treatment with a daily oral dose of the new food supplement BL, AM or placebo, plus diet, the main outcome was the decrease of LDL-C, total cholesterol (TC), and triglyceride levels.

Can Drainage Using a Negative-Pressure Wound Therapy Device Replace Traditional Sample Collection Methods?

Background: In 2015 a new device for the collection of mediastinal fluid from patients with deep sternal wound infection (DSWI) in the presence of negative-pressure wound therapy (NPWT) became available. The present study was designed to evaluate whether changing sample collection devices increased micro-organism detection in patients undergoing NPWT.

Methods: During 2013-2014, 207 samples were collected and cultured from NPWT patients (n = 23) to demonstrate the presence of DSWI using reticulated polyurethane sponge culture, a swab, and blood culture.

Burden of illness in fibromyalgia patients with comorbid depression.

Objectives: To assess the burden of fibromyalgia (FM) in patients with FM taking antidepressant medication for comorbid depression.

Methods: Symptom burden, impact on work and activity, and healthcare resource utilisation (HCRU) was examined at randomisation in patients enrolled in a clinical trial. Symptom burden was estimated based on self-reported health status measures.

Is there continued evidence for an association between abacavir usage and myocardial infarction risk in individuals with HIV? A cohort collaboration.

Background: In March 2008, the D:A:D study published results demonstrating an increased risk of myocardial infarction (MI) for patients on abacavir (ABC). We describe changes to the use of ABC since this date, and investigate changes to the association between ABC and MI with subsequent follow-up.

Methods: A total of 49,717 D:A:D participants were followed from study entry until the first of an MI, death, 1 February 2013 or 6 months after last visit.

Improvements over time in short-term mortality following myocardial infarction in HIV-positive individuals.

Objective: Few studies have described mortality and clinical outcomes after myocardial infarction (MI) in the HIV-positive population. This study evaluated changes in short-term mortality after MI in HIV-positive individuals in the D:A:D Study, and investigated possible reasons for any changes seen.

Design: Prospective cohort study.

Use of antiretroviral therapy and risk of end-stage liver disease and hepatocellular carcinoma in HIV-positive persons.

Objectives: Although several antiretroviral drugs, including the d-drugs stavudine (d4T) and didanosine (ddI), may cause biomarker-defined hepatotoxicity, their association with clinically defined end-stage liver disease (ESLD) and hepatocellular carcinoma (HCC) remains unknown.

Design: Prospective cohort study.

Methods: Data collection on adverse events of anti-HIV drugs study (D:A:D) participants were followed until the first of ESLD (variceal bleeding, hepatic encephalopathy, hepatorenal syndrome or liver transplantation), HCC (histology or α-fetoprotein along with imaging), death, 6 months after last visit or 1 February 2014.

Immunology of membranous nephropathy: from animal models to humans.

Membranous nephropathy (MN), the leading cause of nephrotic syndrome in adults, is characterized by the deposition of subepithelial immune deposits that consist mainly of immunoglobulin (Ig)G and complement. Most of the cases are primary or idiopathic (iMN), while only approximately 25% of the cases are secondary to some known disease such as systemic lupus erythematosus, hepatitis B, drugs and malignancies. Most of our knowledge on the pathogenesis of iMN has relied upon old experimental models (i.

Diffusion and transmission of carbapenem-resistant Klebsiella pneumoniae in the medical and surgical wards of a university hospital in Milan, Italy.

Carbapenem-resistant Klebsiella pneumoniae (CRKP) is emerging as a public health problem worldwide. In Italy, a remarkable increase in CRKP cases has been reported since 2010. In this study, CRKP diffusion, distribution and in-hospital transmission trends were evaluated in a university hospital in Milan, Italy, from January 2012 to December 2013.

Efficacy and Safety of Pregabalin in Patients with Fibromyalgia and Comorbid Depression Taking Concurrent Antidepressant Medication: A Randomized, Placebo-controlled Study.

Objective: To assess pregabalin efficacy and safety in patients with fibromyalgia (FM) with comorbid depression taking concurrent antidepressant medication.

Methods: This randomized, placebo-controlled, double-blind, 2-period, 2-way crossover study was composed of two 6-week treatment periods separated by a 2-week taper/washout phase. Patients with FM (aged ≥ 18 yrs) taking a stable dose of a selective serotonin reuptake inhibitor (SSRI) or a serotonin/norepinephrine reuptake inhibitor (SNRI) for depression were randomized 1:1 to receive pregabalin/placebo or placebo/pregabalin (optimized to 300 or 450 mg/day).

[HIV infection and associated kidney disease].

A wide spectrum of kidney diseases is observed in patients with HIV infection and renal involvement. After the introduction of highly active antiretroviral treatment (ART), the survival of patients has increased and the pattern of chronic kidney diseases changed. There has been a reduction in the prevalence of diseases more strictly related to HIV infection and an increase in comorbid conditions like diabetic nephropathy, nephroangiosclerosis, HCV hepatitis and drug-related tubulointerstitial nephritis, in particular related to antiretroviral drugs.

Reasons for refusal of admission to intensive care and impact on mortality.

Purpose: To identify factors influencing triage decisions and investigate whether admission to the intensive care unit (ICU) could reduce mortality compared with treatment on the ward.

Methods: A multicentre cohort study in 11 university hospitals from seven countries, evaluating triage decisions and outcomes of patients referred for admission to ICU who were either accepted, or refused and treated on the ward. Confounding in the estimation of the effect of ICU admission on mortality was controlled by use of a propensity score approach, which adjusted for the probability of being admitted.

[The "Appropriatezza ECO Milano" project. Assessment of appropriateness of indications, prescriptions and clinical utility of two-dimensional Doppler echocardiography among inpatients and outpatients of Milan, Italy].

Background: The value of echocardiography in the diagnosis and follow-up of most cardiovascular diseases is well established, even though the ever-increasing demand for the use of this technique is not always justifiable. The "Appropriatezza ECO Milano" project was developed among hospitals in Milan (Italy) to foster a rational use of echocardiography. The aim of this study was to evaluate and improve appropriateness of requests for two-dimensional color Doppler echocardiography, considering indications, prescription behaviors and clinical utility in both the outpatient and inpatient settings.

HIV-induced immunodeficiency and mortality from AIDS-defining and non-AIDS-defining malignancies.

Objective: To evaluate deaths from AIDS-defining malignancies (ADM) and non-AIDS-defining malignancies (nADM) in the D:A:D Study and to investigate the relationship between these deaths and immunodeficiency.

Design: Observational cohort study.

Methods: Patients (23 437) were followed prospectively for 104 921 person-years.

[Retrospective analysis of the accidents causing work inability in a teaching hospital during the time 2002-2006].

This study is a retrospective inquiry, based on the data of University Hospital "L. Sacco" in the period of five years 2002-2006. They were analyzed the relevant data to beyond 350 events cause of working inability.

[Implementation of a safety and health planning system in a teaching hospital].

University Hospital "L. Sacco" had started in 2006 a two-year project in order to set up a "Health and Safety Management System (HSMS)" referring to the technical guideline OHSAS 18001:1999 and the UNI and INAIL "Guidelines for a health and safety management system at workplace". So far, the following operations had been implemented: Setting up of a specific Commission within the Risk Management Committee; Identification and appointment of Departmental Representatives of HSMS; Carrying out of a training course addressed to Workers Representatives for Safety and Departmental Representatives of HSMS; Development of an Integrated Informative System for Prevention and Safety; Auditors qualification; Inspection of the Occupational Health Unit and the Prevention and Safety Service: reporting of critical situations and monitoring solutions adopted.

The mesenteric and antimesenteric site of the tumor as possible prognostic factor in colorectal cancer: 5-year survival analysis.

Introduction: Colorectal cancer is still one of the many factors of death both in males and in females. To date, the most important prognostic factors are mainly related to the pathological stage of the disease.

Aim Of The Study: The purpose of this study was to analyze the possible role of tumor circumferential localization on the colonic wall (mesenteric (M) or antimesenteric (AM)) as a possible prognostic factor.

[Early rheumatoid arthritis].

Rheumatoid arthritis (RA) is a systemic disease characterized by chronic inflammation of the synovial joints damage and loss of the function. The ultimate goal in managing RA is to prevent joint damage and to maintain functional ability. Consequently, early diagnosis and treatment is important, but predictive markers for RA are still confined to autoantibodies and also magnetic resonance imaging (MRI) and sonography do not appear to sufficiently distinguish between early RA and non RA.

Hybrid technique for total arch repair: aortic neck reshaping for endovascular-graft fixation.

Purpose: Endovascular repairs of the aortic arch aneurysms require correct placement and an appropriate landing zone for fixation, which are not present in the majority of cases.

Description: We report a less invasive approach in 4 patients presenting an aortic arch aneurysm. We performed a hybrid procedure that is a combination of different techniques: a mid-sternotomy is performed, followed by transposition of the supra-aortic vessels, and neck reshaping with a proximal banding of the aortic arch.

Evaluating daily nursing use and needs in the intensive care unit: a method to assess the rate and appropriateness of ICU resource use.

Background: We designed a tool to measure the rate and appropriateness of intensive care unit (ICU) nursing coverage as a proxy for the use of resources.

Methods: We tested the tool in 32 Italian ICUs during a cross-sectional study (4 days/week, October 2001 and April 2002). The level of care was classified as high or low.

Sedation in the critically ill ventilated patient: possible role of enteral drugs.

Objective: Sedation by the enteral route is unusual in intensive medicine. We analysed the feasibility/efficacy of long-term enteral sedation in ventilated critically ill patients.

Design: Prospective interventional cohort study.

Effectiveness and efficiency of intensive care medicine: variable costs in different diagnosis groups.

Background: To establish the effectiveness of ICU treatment and the efficiency in the use of resources in patients stratified according to 10 diagnosis and two levels-of-care. To propose strategies aimed at reducing costs and improving efficiency in each patient group.

Methods: Multicentre prospective observational study.

[Efficacy of medical therapy in preventing the post-surgical recurrence in Crohn's disease].

Crohns Disease (CD) is a chronic intestinal inflammatory disease of unknown origins that cannot be definitely resolved with surgical intervention. Therefore, pharmacologic therapies are of great importance both in preventing relapses and by determining remissions. In this paper the authors analyse the different drugs available for the treatment of Crohns disease, and focus on their efficacy and tollerability.

Perianal fistulae following infliximab treatment: clinical and endosonographic outcome.

Background: Management of perianal and rectovaginal fistulae complicating Crohn's disease (CD) is unsatisfactory. Infliximab is effective in the treatment of fistulating CD. However, reopening of fistulae is frequent, suggesting the persistence of deep fistula tracts despite superficial healing.

Volume of activity and occupancy rate in intensive care units. Association with mortality.

Objective: Mortality after many procedures is lower in centers where more procedures are done. It is controversial whether this is true for intensive care units, too. We examined the relationship between the volume of activity of intensive care units (ICUs) and mortality by a measure of risk-adjusted volume of activity specific for ICUs.