BACKGROUND & AIMS: :Only 2 previous studies, conducted in Australia, United States and northern Europe, considered the role of dietary fibre intake on renal cell carcinoma (RCC) risk, and both showed a modest, inverse association. Therefore, we investigated in depth the topic of fibres and RCC, using data from a multicenter case-control study conducted in Italy from 1992 to 2004, including 767 cases with incident, histologically confirmed RCC and 1,534 controls admitted to the same network of hospitals as cases with acute nonmalignant conditions. Multivariate odds ratios (OR) and 95% confidence intervals (CI) were obtained after allowance for major identified confounding factors, including total energy intake. The continuous OR for an increase in intake equal to the difference between the 80th and the 20th percentile were 0.94 (95% CI: 0.82-1.08) for total dietary fibre, 0.98 (95% CI: 0.85-1.13) for soluble noncellulose polysaccharides, 0.92 (95% CI: 0.80-1.05) for total insoluble fibre, 0.90 (95% CI: 0.78-1.04) for cellulose, 0.95 (95% CI: 0.84-1.06) for insoluble noncellulose polysaccharides and 1.06 (95% CI: 0.93-1.21) for lignin. With reference to the sources of fibre, we found an inverse association with vegetable fibre (OR = 0.84, 95% CI: 0.73-0.97), but no association with fruit (OR = 0.98, 95% CI: 0.86-1.12) and grain fibre (OR = 1.05, 95% CI: 0.95-1.15). The inverse association with vegetable fibre may reflect a real favorable effect, or be an indicator of a beneficial role of a diet rich in vegetable on RCC risk.

背景与目标： ：以前在澳大利亚，美国和北欧进行的两项研究仅考虑膳食纤维摄入对肾细胞癌（RCC）风险的作用，并且两者均显示出适度的逆相关性。因此，我们使用来自1992年至2004年在意大利进行的多中心病例对照研究的数据，深入研究了纤维和RCC的主题，其中包括767例经组织学证实为RCC的事件，并经与组织相同的医院网络接受了1,534例对照急性非恶性疾病的病例。在考虑到主要确定的混杂因素（包括总能量摄入）后，获得了多元比值比（OR）和95％置信区间（CI）。膳食总纤维的摄入量增加的连续OR等于第80个百分点与第20个百分点之间的差异，为0.94（95％CI：0.82-1.08），可溶性非纤维素多糖为0.98（95％CI：0.85-1.13），总不溶性纤维为0.92（95％CI：0.80-1.05），纤维素为0.90（95％CI：0.78-1.04），不溶性非纤维素多糖为0.95（95％CI：0.84-1.06）和1.06（95％CI：0.93） -1.21）为木质素。关于纤维的来源，我们发现与植物纤维呈负相关（OR = 0.84，95％CI：0.73-0.97），但与水果（OR = 0.98，95％CI：0.86-1.12）和谷物没有关联。纤维（OR = 1.05，95％CI：0.95-1.15）。与植物纤维的反向关联可能反映出真正的有利作用，或者表明富含蔬菜的饮食对RCC风险的有益作用。

BACKGROUND & AIMS: AIMS:to report the incidence, characteristics, and outcome of in-hospital cardiac arrest (IHCA) in a large Italian region. SETTING:all hospitals participating in the IHCA Registry Initiative of Piedmont. METHODS:observational cohort study in adult (>18year old) inpatients resuscitated from IHCA during three consecutive years (2012-2014). The main outcome measures were IHCA incidence and survival to hospital discharge. RESULTS:A total of1539 arrests in adult inpatients were recorded in the study period, yielding an overall incidence of 1.51 arrests/1000 admissions. The incidence was highest at day 1 after hospital admission and in the morning hours, with a peak at 9.00 a.m. Median age was 77 (interquartile range 68-83) years. The presenting rhythm was ventricular fibrillation/pulseless ventricular tachycardia in 291/1539 (18.9%) cases. A total of 549/1539 (35.7%) patients achieved recovery of spontaneous circulation (ROSC) and 228/1539(14.8%) survived hospital discharge, with 207 (90.8%) of the latter having good neurological outcome (Cerebral Performance Categories [CPC] 1 or 2).After adjustment for major confounders, a pre-arrest CPC=1, a cardiac cause of arrest, a shockable presenting rhythm, and a shorter duration of resuscitation were independently associated with a higher likelihood of survival to discharge. CONCLUSIONS:in this Italian registry the incidence of IHCA and its circadian distribution were comparable to those in the NCAA registry in the UK. Patients were older and had a lower ROSC rate than these observed in other large IHCA registries, but post-ROSC survival rate and factors affecting survival to discharge were similar.

背景与目标： 目的：报告意大利大面积医院内心脏骤停（IHCA）的发生率，特征和结局。
地点：所有参加皮埃蒙特IHCA注册计划的医院。
方法：连续三年（2012-2014年）从IHCA复苏的成人（> 18岁）住院患者的观察性队列研究。主要结果指标是IHCA发生率和出院生存率。
结果：在研究期间，共记录了1539名成人住院患者的逮捕事件，每1000例入院患者的总发病率为1.51次。发病率最高的是入院后第1天和早晨，最高时是上午9.00点，中位年龄为77岁（四分位间距为68-83岁）。出现的节律为室颤/无脉性室性心动过速，发生在291/1539例中（占18.9％）。共有549/1539（35.7％）的患者实现了自发性循环（ROSC）的恢复，并且有228/1539（14.8％）的患者在出院后存活，其中207（90.8％）的患者具有良好的神经系统转归（脑功能分类[CPC] ] 1或2）。在对主要混杂因素进行调整之后，逮捕前的CPC = 1，心脏骤停的原因，令人震惊的呈现节律和较短的复苏持续时间与更高的出院生存率独立相关。
结论：在该意大利注册中心中，IHCA的发生率及其昼夜节律分布与英国的NCAA注册中心相当。患者年龄较大，ROSC率低于其他大型IHCA登记处，但ROSC后生存率和影响出院生存率的因素相似。

BACKGROUND & AIMS: BACKGROUND:Many studies on migrant health have focused on aspects of morbidity and mortality, but very few approach the relevant issues of migrants' health considering behavioral risk factors. Previous studies have often been limited methodologically because of sample size or lack of information on migrant country of origin. Information about risk factors is fundamental to direct any intervention, particularly with regard to non-communicable diseases that are leading causes of death and disease. Thus, the main focus of our analysis is the influence of country of origin and the assimilation process. METHOD:Utilizing a surveillance system that has been collecting over 30,000 interviews a year in Italy since 2008, we have studied migrants' attitudes and behaviors by country of origin and by length of stay. Given 6 years of observation, we have obtained and analyzed 228,201 interviews of which over 9000 were migrants. RESULTS:While migrants overall present similar conditions to native-born Italians, major differences appear when country of origin or length of stay is considered. Subgroups of migrants present substantially different behaviors, some much better than native-born Italians, some worse. However, integration processes generally produce a convergence towards the behavioral prevalence observed for native-born Italians. CONCLUSIONS:Health programs should consider the diversity of the growing migrant population: data and analyses are needed to support appropriate policies. Many migrants' subgroups arrive with healthier behaviors than those of their adopted country. However, they are likely to have a less favorable social position in their destination countries that could lead to a change towards less healthy behaviors. Interventions capable of identifying this tendency could produce significant better health for this important part of the future (multicultural) populations.

背景与目标： 背景：关于移民健康的许多研究都集中在发病率和死亡率方面，但很少考虑行为危险因素来解决移民健康的相关问题。由于样本量大或缺乏有关移民原籍国的信息，以前的研究通常在方法上受到限制。有关危险因素的信息对于指导任何干预至关重要，特别是对于导致死亡和疾病的非传染性疾病尤其如此。因此，我们分析的主要重点是原籍国和同化过程的影响。
方法：自2008年以来，我们使用一种监视系统，该系统每年在意大利收集了30,000多次采访，我们研究了移民的态度和行为，包括其原籍国和居留时间。经过6年的观察，我们获得并分析了228,201份访谈，其中9000多人是移民。
结果：虽然移民总体上与本地出生的意大利人具有相似的条件，但是当考虑到原籍国或居留时间时，会出现主要差异。移民群体表现出截然不同的行为，有些表现得比本地出生的意大利人好得多，有些则更糟。但是，融合过程通常会朝着本土出生的意大利人所观察到的行为普遍性趋同。
结论：卫生计划应考虑不断增长的移民人口的多样性：需要数据和分析来支持适当的政策。许多移民亚群体的行为比其被收养国家的行为更健康。但是，他们在目的地国家的社会地位可能会较差，这可能导致人们朝着不健康的行为转变。能够识别这种趋势的干预措施可以为未来（多元文化）人口的这一重要部分带来显着改善的健康状况。

BACKGROUND & AIMS: BACKGROUND:Male breast cancer (MBC) is a rare and scarcely investigated disease. The strongest genetic risk factor for MBC is represented by inherited BRCA2 mutations, whereas the association between MBC and BRCA1 mutations is less clear. MBC appears to be biologically similar to breast cancer in females, however the phenotypic characteristics of BRCA1/2-related MBCs are not yet well elucidated. OBJECTIVE:To investigate the genetic and phenotypic characteristics of MBC in a large and well-characterized population-based series of 108 MBCs from Tuscany (Central Italy) and to evaluate associations between BRCA1/BRCA2 mutation status and clinical-pathological features including breast/ovarian cancer first-degree family history, tumor histology and grade, proliferative activity, estrogen/progesterone receptors (ER/PR) and epidermal growth factor receptor 2 (HER2) expression. Results BRCA1/BRCA2 mutations were identified in ten MBCs, in particular, two cases (1.9%) carried BRCA1 and eight cases (7.4%) carried BRCA2 mutations. The same BRCA1 mutation (3347delAG) was detected in two unrelated MBC cases. Three novel BRCA2 pathogenic mutations were found. Statistically significant associations emerged between BRCA2-related tumors and absence of PR expression (P = 0.008), HER2 over-expression (P = 0.002) and high tumor grade (P = 0.005). Conclusions Here, we (i) reported that in our population about 9% of MBC cases are accounted for by BRCA1/BRCA2 mutations; (ii) enlarged the BRCA2 mutational spectrum and (iii) characterized a specific phenotype associated with BRCA2-related MBCs suggestive of aggressive behavior. Overall, our results may have important implications on clinical management for this rare disease.

背景与目标： 背景：男性乳腺癌（MBC）是一种罕见且鲜有研究的疾病。 MBC的最强遗传风险因子由遗传的BRCA2突变代表，而MBC和BRCA1突变之间的关联尚不清楚。在女性中，MBC在生物学上似乎与乳腺癌相似，但是与BRCA1 / 2相关的MBC的表型特征尚未得到很好的阐明。
目的：研究来自托斯卡纳（意大利中部）的一个大型且特征明确的基于人群的108 MBCs系列中MBC的遗传和表型特征，并评估BRCA1 / BRCA2突变状态与临床病理特征（包括乳腺癌/卵巢癌）之间的关联癌症一级家族史，肿瘤组织学和等级，增殖活性，雌激素/孕激素受体（ER / PR）和表皮生长因子受体2（HER2）的表达。结果在10个MBCs中鉴定出BRCA1 / BRCA2突变，特别是2例（1.9％）携带BRCA1，8例（7.4％）携带BRCA2突变。在两个无关MBC病例中检测到相同的BRCA1突变（3347delAG）。发现了三个新的BRCA2致病突变。在与BRCA2相关的肿瘤与PR表达缺失（P = 0.008），HER2过表达（P = 0.002）和高肿瘤分级（P = 0.005）之间出现了统计学上显着的关联。结论在这里，我们（i）报告说，在我们的人群中，约9％的MBC病例是由BRCA1 / BRCA2突变引起的； （ii）扩大了BRCA2突变谱，并且（iii）表征了与BRCA2相关的MBC相关的特定表型，暗示了攻击行为。总体而言，我们的结果可能会对这种罕见疾病的临床治疗产生重要影响。

BACKGROUND & AIMS: INTRODUCTION:Very limited information exists from Italian hospitals about the utilization and expenditure of medical devices. The ratio expenditure/DRG reimbursement (expressed as a percentage) is a useful parameter, particularly when it is separately calculated for each individual Azienda and, within each Azienda, according to the medical discipline. AREAS COVERED:To generate benchmarks in this area, we have made reference to the expenditure incurred for medical devices from January to June 2019 in all hospitals of the Tuscany region. These expenditures divided by medical discipline have been compared with the DRG reimbursements that hospitals receive from our Region for the same disciplines. This benchmark is represented by percent ratio expenditure/reimbursement for each of the eight Aziende and, within each Azienda, according to the medical specialty. EXPERT OPINION:These percentages indicate, for each medical discipline, to what extent medical devices typically consume the reimbursement resulting from the DRGs. These benchmarks facilitate the interpretation of values estimated locally. Determinants leading to 'excessive' values (e.g. >100%) of this parameter can include an extensive use of costly devices, a high frequency of non-remunerative procedures, the presence of inappropriate treatments, the need to update specific DRGs, deficiencies in coding expenditures and procedures, and so on.

背景与目标： 简介：意大利医院提供的有关医疗设备使用和支出的信息非常有限。支出/ DRG偿还比率（以百分比表示）是一个有用的参数，特别是当根据医学学科分别针对每个单独的Azienda以及在每个Azienda中计算时。
覆盖的区域：为了制定该领域的基准，我们参考了2019年1月至2019年6月托斯卡纳地区所有医院医疗设备的支出。将这些支出除以医学科目后与医院从本地区获得的相同科目的DRG报销进行了比较。根据医疗专业，该基准由八个Aziende中的每一个以及在每个Azienda中的百分比支出/报销来表示。
专家意见：对于每个医学学科，这些百分比表示医疗设备通常在多大程度上消耗DRG产生的报销。这些基准有助于解释本地估计的值。导致该参数“过高”值（例如> 100％）的决定因素可能包括：广泛使用昂贵的设备，高频率的非补偿性程序，存在不适当的治疗方法，需要更新特定的DRG，编码方面的缺陷支出和程序等。

BACKGROUND & AIMS: BACKGROUND:Research was carried out in the years 2002-2003 into food, flavouring and feed folk traditions of plants in the Tyrrhenian part of the Basilicata region (southern Italy). This area was colonized in ancient times by Greeks. Data was collected through field interviews, especially of farmers. METHODS:Field data were collected through structured interviews. The informants, numbered 49, belonged to families which had strong links with the traditional activities of the area. RESULTS:61 taxa are cited, belonging to 26 botanical families, amongst which 44 used as food or flavouring and 22 for animal alimentation. Besides 7 taxa are involved in rituals especially connected with agriculture and plant growth. CONCLUSION:The preservation of some rituals especially concerning agricultural plants is noteworthy in the area, together with a certain degree of continuity in food uses. Knowledge and rediscovery of recipes in human and animal diet could represent an economic potential for the area.

背景与目标： 背景：在2002年至2003年间，对巴西利卡塔地区（意大利南部）第勒尼安地区的食物，调味料和饲料民间习俗进行了研究。该地区在古代被希腊人殖民。通过田间访谈，尤其是农民的访谈收集了数据。
方法：通过结构化访谈收集现场数据。线人49名属于与该地区的传统活动有密切联系的家庭。
结果：共有61个分类单元，属于26个植物科，其中44个用作食物或调味剂，22个用作动物营养。此外，还有7个分类单元参与了与农业和植物生长特别相关的仪式。
结论：在该地区值得注意的是保存某些仪式，特别是有关农业植物的仪式，并且在食品使用方面具有一定程度的连续性。在人类和动物饮食中的知识和食谱的重新发现可能代表该地区的经济潜力。

BACKGROUND & AIMS: :Between the sixteenth and twentieth centuries, the study of biology was intimately intertwined with progress in medicine. So how, when and where did research into the life sciences begin?

背景与目标： 在十六和二十世纪之间，生物学的研究与医学的发展息息相关。那么，如何开始，何时何地开始对生命科学的研究呢？

BACKGROUND & AIMS: STUDY QUESTION:Was the delivery rate of ART cycles negatively affected by the enactment of the Law 40/2004 by the Italian Parliament which imposed a long list of restrictions for ART procedures? SUMMARY ANSWER:This large and extensive comparative analysis of ART outcomes prior to and after the introduction of the Law 40 revealed a significant reduction in pregnancy and delivery rates per cycle, independent of age or other clinical variables, once the law went into effect. WHAT IS KNOWN ALREADY:Several studies have been published on the effect of Law 40/2004 on ART outcomes, some authors demonstrating a negative impact of the Law in relation to specific etiologies of infertility, other authors showing opposite conclusions. STUDY DESIGN, SIZE, DURATION:Retrospective clinical study of 3808 patients treated prior to the enactment of the Law, September 1996-March 2004 (Group I) and 6898 treated during the Law, March 2004-May 2009 (Group II). PARTICIPANTS/MATERIALS, SETTING, METHODS:A total of 10 706 ART cycles were analysed, 3808 performed before and 6898 after the application of the Law. An intention-to-treat statistical analysis was performed to detect pregnancy and delivery rates (pregnancies ≥ 24 weeks) per started cycle. A P value of <0.05 was considered statistically significant. We analysed different outcomes: differences in fertilization, pregnancy and delivery rate, multiple pregnancies and miscarriage rates between the two time periods. MAIN RESULTS AND THE ROLE OF CHANCE:The delivery rate for started cycle was 20% before and 16.0% after the introduction of the Law representing a 25% reduction (P < 0.001). The multivariate analysis, corrected by female age of >38 years, duration of infertility, basal FSH level and number of retrieved oocytes, showed a 16% lower delivery rate (odds ratio: 0.84; confidence interval: 0.75-0.94). This statistical approach removed the risk that the observed effects were due to chance and confirmed unequivocally that the Law was an independent factor responsible for the reduced likelihood of a successful outcome. LIMITATIONS, REASONS FOR CAUTION:This is a retrospective study. A prospective randomized study, with patients treated in the same time period and randomized to restrictions or not, would have minimized potential limitations due to differences in years of treatments. WIDER IMPLICATIONS OF THE FINDINGS:Our findings based on the analysis of such a large number of cycles proved clearly and unequivocally that imposing restrictions on the practice of ART penalized patients. These data represent a relevant clinical contribution for countries still debating the enactment of restrictive limitations of ART.

背景与目标： 研究问题：意大利议会颁布的第40/2004号法律对ART程序的限制有很长的清单吗，ART周期的交付率是否受到负面影响？
总结：这项对法律出台之前和之后的ART结果的大型且广泛的比较分析[40]显示，一旦该法律生效，每个周期的怀孕和分娩率将显着降低，而不受年龄或其他临床变量的影响。
已经知道的内容：关于40/2004号法律对抗逆转录病毒疗法疗效的影响已经发表了几项研究，一些作者证明了该法律对不育症的具体病因产生了负面影响，另一些作者则提出了相反的结论。
研究设计，大小，时间：1996年9月至2004年3月（第一组）实施该法之前接受治疗的3808例患者的回顾性临床研究，以及2004年3月至2009年5月（第二组）在该法实施期间接受治疗的6898例患者的回顾性临床研究。
参与者/材料，设置，方法：共分析了10706个ART周期，在实施该法律之前进行了3808次，在实施该法律后进行了6898次。进行意向性治疗统计分析，以检测每个开始周期的妊娠和分娩率（≥24周的怀孕）。 P值<0.05被认为具有统计学意义。我们分析了不同的结局：两个时间段之间受精，妊娠和分娩率，多次妊娠和流产率的差异。
主要结果和机会作用：该法实施之前，开始生产周期的交付率为20％，而实施后为16.0％，降低了25％（P <0.001）。多元分析经女性年龄> 38岁，不育时间，基础FSH水平和取回的卵母细胞数量校正，显示分娩率降低了16％（比值比：0.84；置信区间：0.75-0.94）。这种统计方法消除了观察到的结果归因于偶然性的风险，并明确确认该法律是导致成功结局可能性降低的独立因素。
局限性，警告原因：这是一项回顾性研究。一项前瞻性随机研究将患者在相同时间段内接受治疗并随机分配至限制条件，由于治疗年限的不同，其潜在的限制条件已降至最低。
结果的更广泛含义：基于对如此大量周期的分析，我们的发现清楚而明确地证明了对接受ART处罚的患者的行为施加了限制。这些数据代表了仍在争论抗逆转录病毒疗法的限制性限制颁布的国家的相关临床贡献。

BACKGROUND & AIMS: OBJECTIVES:The aim of this study was to establish a national Early Awareness and Alert (EAA) system for the identification and assessment of new and emerging health technologies in Italy. METHODS:In 2008, Agenas, a public body supporting Regions and the Ministry of Health (MoH) in health services research, started a project named COTE (Observatory of New and Emerging Health Technologies) with the ultimate aim of implementing a national EAA system. The COTE project involved all stakeholders (MoH, Regions, Industry, Universities, technical government bodies, and Scientific Societies), in defining the key characteristics and methods of the EAA system. Agreement with stakeholders was reached using three separate workshops. RESULTS:During the workshops, participants shared and agreed methods for identification of new and emerging health technologies, prioritization, and assessment. The structure of the Horizon Scanning (HS) reports was discussed and defined. The main channels for dissemination of outputs were identified as the EuroScan database, and the stakeholders' Web portals. During the final workshop, Agenas presented the first three HS reports produced at national level and proposed the establishment of a permanent national EAA system. CONCLUSIONS:The COTE Project created the basis for a permanent national EAA system in Italy. An infrastructure to enable the stakeholders network to grow was created, methods to submit new and emerging health technologies for possible evaluation were established, methods for assessment of the technologies selected were defined, and the stakeholders involvement was delineated (in the identification, assessment, and dissemination stages).

背景与目标： 目的：本研究的目的是建立一个意大利的早期意识和警报（EAA）系统，用于识别和评估意大利的新兴健康技术。
方法：2008年，支持地区和卫生部（MoH）进行公共卫生服务研究的公共机构Agenas，启动了一个名为COTE（新的和新兴卫生技术观察站）的项目，其最终目的是实施国家EAA系统。 COTE项目涉及所有利益相关者（卫生部，地区，工业，大学，技术政府机构和科学协会），以定义EAA系统的关键特征和方法。通过三个单独的讲习班与利益相关者达成了协议。
结果：在研讨会期间，与会人员共享并商定了用于识别新的和新兴的卫生技术，确定优先次序和进行评估的方法。讨论并定义了“地平线扫描（HS）”报告的结构。确定了传播输出的主要渠道，即EuroScan数据库和利益相关者的Web门户。在最后的研讨会上，Agenas介绍了在国家层面上生成的前三份HS报告，并建议建立永久性的国家EAA系统。
结论：COTE项目为意大利的永久性国家EAA系统奠定了基础。建立了使利益相关者网络发展的基础设施，建立了提交新的和新兴的卫生技术以进行可能评估的方法，定义了评估所选技术的方法，并确定了利益相关者的参与（在识别，评估和评估中）。传播阶段）。

BACKGROUND & AIMS: BACKGROUND:An inverse relationship between hospital volume and death following pancreatico duodenectomy (PD) has been reported from several countries. The aim of this study was to assess the volume-outcome effect of PD in Italy. METHODS:The study group comprised 1576 patients who underwent PD in 2003. Hospitals were allocated to four volume groups: low volume, five PDs or fewer; medium volume, six to 13 PDs; high volume, 14 to 51 PDs; and very high volume, two hospitals that performed 89 and 104 PDs. RESULTS:Some 221 hospitals performed at least one PD in 2003; hospital volume was low in 74.7 per cent, medium in 17.6 per cent, high in 6.8 per cent and very high in 0.9 per cent. The overall mortality rate was 8.1 per cent. Increasing hospital volume was associated with a significantly reduced mortality rate: 12.4 per cent (adjusted odds ratio (OR) 1.000) for low-volume, 7.8 per cent (OR 0.611) for medium-volume, 5.9 per cent (OR 0.466) for high-volume and 2.6 per cent (OR 0.208) for very high-volume hospitals. Length of postoperative stay was reduced in very high-volume hospitals (P < 0.001). CONCLUSION:The outcome of PD in Italy is dependent on hospital volume and a policy of centralization may therefore be appropriate.

背景与目标： 背景：胰岛十二指肠切除术（PD）术后的医院数量与死亡之间存在负相关关系。这项研究的目的是评估意大利的PD的结局结果。
方法：该研究组包括2003年接受PD的1576例患者。医院分为四个容量组：低容量，五个PD或更少，五个PD。中等容量，6到13个PD；大容量14到51个PD；并且数量非常庞大，两家医院分别执行了89次和104次PD​​。
结果：2003年，有221所医院至少进行了一次PD检查；医院住院率较低，为74.7％，中度为17.6％，高为6.8％，极高为0.9％。总死亡率为8.1％。医院数量的增加与死亡率的显着降低有关：小批量患者为12.4％（调整后的优势比（OR）1.000），中型患者为7.8％（OR 0.611），高水平为5.9％（OR 0.466）量的医院，则为2.6％（OR 0.208）。在大型医院中，术后住院时间缩短了（P <0.001）。
结论：意大利PD的结局取决于医院规模，因此采取集中化政策可能是适当的。

BACKGROUND & AIMS: :The cases are described of two infants who developed clinical and laboratory signs of congenital syphilis in Northern Italy, a region where the disease had not been documented for several years. The report urges greater vigilance and screening for syphilis among pregnant women and newborns, and contributes to the evidence that the incidence of syphilis is rising among women in Italy.

背景与目标： ：这些病例描述了在意大利北部地区出现先天性梅毒的临床和实验室体征的两名婴儿，该地区多年未发现该病。该报告敦促提高孕妇和新生儿梅毒的警惕性和筛查，并提供证据证明意大利女性梅毒的发病率正在上升。

BACKGROUND & AIMS: :In the light of using biomaterial as pollutants sorbents for the environmental biomonitoring, we report here the results of the absorption of polycyclic aromatic hydrocarbons (PAHs) by pine bark. Quantitative analysis of 19 different polycyclic aromatic compounds was performed, after Soxhlet extraction in dichloromethane, by means GC-MS technique. Pinus was chosen due to its wide distribution in the Mediterranean area. The passive absorption of PAH by pine bark in the metropolitan areas allowed us to evaluate the air quality of Palermo. The obtained results showed a very high range of PAHs concentrations, from 33 microg/kg (bark dry weight), as SigmaPAHs, at the control site to 1015 microg/kg along a road with high traffic flow.

背景与目标： ：鉴于使用生物材料作为环境生物监测的污染物吸附剂，我们在此报告松树皮吸收多环芳烃（PAHs）的结果。用GC-MS技术在二氯甲烷中索氏提取后，对19种不同的多环芳族化合物进行了定量分析。选择松属植物是由于其在地中海地区的广泛分布。大城市地区的松树皮对PAH的被动吸收使我们能够评估巴勒莫的空气质量。所获得的结果表明，PAHs的浓度范围非常高，从SigmaPAHs的33微克/千克（树皮干重）到对照地点，到交通流量大的道路上的PAHs浓度为1015微克/千克。

BACKGROUND & AIMS: OBJECTIVE:To determine the accuracy of drug-susceptibility testing (DST) for isoniazid, rifampicin, ethambutol and streptomycin in a provisional network of 22 regional laboratories in Italy. METHODS:Methods, definitions and reference Mycobacterium tuberculosis strains were derived from the WHO/IUATLD Global Project on Anti-tuberculosis Drug Resistance Surveillance. The laboratories were selected based on technical skills required by the project, the number of DST performed annually and geographic localisation. The results (sensitive/resistant strain) were compared with the gold standard (global project results). Sensitivity (ability to detect true resistance), specificity (ability to detect true susceptibility), positive predictive values for resistance and susceptibility, efficiency and reproducibility were calculated in two rounds. RESULTS:Eighteen of 22 laboratories completed the first round of proficiency testing for the four drugs. Sensitivity was 76.6%, specificity 97.2%, predictive value of a resistant test 89.8% and of a susceptible test 86.8%, efficiency 87.8% and reproducibility 92.8%. A second round was performed by all those laboratories that did not achieve > or = 90% agreement with the results of the Global Project. Overall, after the second round, all the parameters except specificity improved, exceeding 90%. CONCLUSIONS:A network of 15 regional laboratories that fulfil the quality criteria for determining the susceptibility of M. tuberculosis to the four primary antituberculosis drugs was established in Italy.

背景与目标： 目的：在意大利由22个地区实验室组成的临时网络中，测定异烟肼，利福平，乙胺丁醇和链霉素的药敏试验（DST）的准确性。
方法：方法，定义和参考结核分枝杆菌菌株均来自WHO / IUATLD全球抗结核药物耐药性监测项目。根据项目所需的技术技能，每年执行的DST数量和地理定位来选择实验室。将结果（敏感/耐药菌株）与金标准（全球项目结果）进行比较。分两轮计算敏感性（检测真正耐药性的能力），特异性（检测真正耐药性的能力），耐药性和敏感性，效率和可重复性的阳性预测值。
结果：22个实验室中的18个完成了对这四种药物的第一轮能力验证。敏感性为76.6％，特异性为97.2％，耐药性测试的预测值为89.8％，易感性测试的预测值为86.8％，效率为87.8％，再现性为92.8％。所有未与全球项目结果达成或超过90％协议的实验室都进行了第二轮。总体而言，在第二轮之后，除特异性以外的所有参数均得到改善，超过90％。
结论：在意大利建立了一个由15个地区实验室组成的网络，这些网络符合确定结核分枝杆菌对四种主要抗结核药物的敏感性的质量标准。

BACKGROUND & AIMS: :Neurologists are interested in understanding whether patients with multiple sclerosis (pwMS) undergoing immunomodulatory/immunosuppressive therapy are more susceptible to developing COVID-19 or have worse outcomes. Currently, there are no conclusive data in this regard. We report the prevalence and severity of COVID-19 (confirmed and possible) in pwMS followed at the Veneto Regional MS Center in Verona (Italy), an area most stricken by COVID-19. In our sample size, the prevalence of COVID-19 seems to be much higher than that officially reported at the regional level on the general population, but it also characterized by a favourable course.

背景与目标： 神经学家对了解正在接受免疫调节/免疫抑制治疗的多发性硬化症（pwMS）患者更容易发展为COVID-19还是预后更差感兴趣。当前，在这方面没有确切的数据。我们报告了pwMS中COVID-19的患病率和严重程度（已确认并可能），随后在意大利维罗纳的威尼托地区MS中心（该地区受COVID-19打击最严重）。在我们的样本量中，COVID-19的患病率似乎比一般人群在区域级别上正式报告的要高得多，但是它的特点是发展过程良好。

BACKGROUND & AIMS: BACKGROUND:Emergency Department (ED) crowding reduces staff satisfaction and healthcare quality and safety, which in turn increase costs. Despite a number of proposed solutions, ED length of stay (LOS) - a main cause of overcrowding - remains a major issue worldwide. This retrospective cohort study was aimed at evaluating the effectiveness on ED LOS of a procedure called "Diagnostic Anticipation" (DA), which consisted in anticipating the ordering of blood tests by nurses, at triage, following a diagnostic algorithm approved by physicians. METHODS:In the second half of 2019, the ED of the University Hospital of Ferrara, Italy, adopted the DA protocol on alternate weeks for all patients with chest pain, abdominal pain, and non-traumatic bleeding. A retrospective cohort study on DA impact was conducted. Using ED electronic data, LOS independent predictors (age, sex, NEDOCS and Priority Color Code, imaging tests, specialistic consultations, hospital admission) were evaluated through multiple regression. RESULTS:During the weeks when DA was adopted, as compared to control weeks, the mean LOS was shorter by 18.2 min for chest pain, but longer by 15.7 min for abdominal pain, and 33.3 for non-traumatic bleeding. At multivariate analysis, adjusting for age, gender, triage priority, specialist consultations, imaging test, hospitalization and ED crowding, the difference in visit time was significant for chest pain only (p < 0.001). CONCLUSIONS:The impact of DA varied by patients' condition, being significant for chest pain only. Further research is needed before the implementation, estimating the potential proportion of inappropriate blood tests and ED crowding status.

背景与目标： 背景：紧急部门（ED）的拥挤降低了员工满意度以及医疗质量和安全性，从而增加了成本。尽管有许多建议的解决方案，但ED停留时间（LOS）是人满为患的主要原因，仍然是全世界的主要问题。这项回顾性队列研究旨在评估一种称为“诊断预期”（DA）的程序对ED LOS的有效性，该程序包括按照医生批准的诊断算法，预测分诊时护士对血液检查的顺序。
方法：2019年下半年，意大利费拉拉大学医院的ED在每隔几周对所有患有胸痛，腹痛和非创伤性出血的患者采用DA方案。进行了一项关于DA影响的回顾性队列研究。使用ED电子数据，通过多元回归评估了LOS独立的预测因素（年龄，性别，NEDOCS和优先颜色代码，影像学检查，专业咨询，入院）。
结果：在采用DA的几周内，与对照组相比，胸痛的平均LOS缩短了18.2 min，腹痛的平均LOS缩短了15.7 min，非创伤性出血的平均LOS缩短了33.3min。在多变量分析中，对年龄，性别，分流优先级，专科医生咨询，影像学检查，住院和ED拥挤进行调整后，就诊时间的差异仅对胸痛有意义（p significant <（0.001）。
结论：DA的影响因患者的病情而异，仅对胸痛有意义。在实施之前，需要进行进一步的研究，以估计不适当的血液检查和ED拥挤状况的潜在比例。