Region Lombardia Research Articles

The Deadly Quartet (Covid-19, Old Age, Lung Disease, and Heart Failure) Explains Why Coronavirus-Related Mortality in Northern Italy Was So High.

Since its outbreak in China at the end of 2019, the new coronavirus disease (COVID-19) was characterized by both easy spreading and high mortality. The latter proved to be way more elevated in the North of Italy -with a peak of 18.4% in region Lombardia and even 31% in the city of Bergamo and surrounding county- than in the rest of the world. In an attempt to conceptualize the reasons for such a dramatic situation, four key elements have been identified: COVID-19 itself, old age, lung disease, and heart failure. Their harmful combination has been named “The deadly quartet”. The underlying risk factors, among which a lot of them are distinctive features of the population in northern Italy, have been summarized as “unmodifiable”, “partially modifiable”, and “modifiable”, for the sake of clarity. Up-to-date scientific evidence in this field has been described in the form of a narrative and easy-to-read review.

Re-organization of the Vascular Surgery Department During the Acute Phase of the COVID19 Outbreak: Lessons Learned and Future Perspectives

IntroductionSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection represents a serious threat to public health because it leads to a wide spectrum of clinical manifestations. The region Lombardia (Italy) has suffered from severe problems during the acute phase of the outbreak in Italy (March–April 2020). The aim of our analysis is to report the experience of the Department of Vascular Surgery of Pavia, including the learned lessons and future perspectives, considering that the COVID-19 outbreak is in its acute phase in other continents.Material and methodsSingle-center, retrospective, observational study based on extracted data from the medical records of all consecutive COVID-19 patients observed in our Vascular Department between March 1st and April 30th, 2020. We reviewed the records for demographic information, comorbidities, laboratory tests, and anticoagulation treatment at the time of hospital admission.ResultsWe observed an important reduction in elective and urgent interventions compared to the same period of the previous year; in parallel, we observed an increase in the diagnosis of deep vein thrombosis (DVT) in hospitalized patients, especially with severe infection. In our department, four infections were reported among health workers.ConclusionsThe impact of the COVID19 pandemic on health-care delivery has been massive. A wave of vascular-related complications is expected. Regular SARS-CoV-2 screening, adequate protection, and quick reorganization of health-care resources are still needed.

On the concentration of SARS-CoV-2 in outdoor air and the interaction with pre-existing atmospheric particles

The spread of SARS-CoV-2 by contact (direct or indirect) is widely accepted, but the relative importance of airborne transmission is still controversial. Probability of outdoor airborne transmission depends on several parameters, still rather uncertain: virus-laden aerosol concentrations, viability and lifetime, minimum dose necessary to transmit the disease. In this work, an estimate of outdoor concentrations in northern Italy (region Lombardia) was performed using a simple box model approach, based on an estimate of respiratory emissions, with a specific focus for the cities of Milan and Bergamo (Italy). In addition, the probability of interaction of virus-laden aerosol with pre-existing particles of different sizes was investigated. Results indicate very low (<1 RNA copy/m3) average outdoor concentrations in public area, excluding crowded zones, even in the worst case scenario and assuming a number of infects up to 25% of population. On average, assuming a number of infects equal to 10% of the population, the time necessary to inspire a quantum (i.e. the dose of airborne droplet nuclei required to cause infection in 63% of susceptible persons) would be 31.5 days in Milan (range 2.7–91 days) and 51.2 days in Bergamo (range 4.4–149 days). Therefore, the probability of airborne transmission due to respiratory aerosol is very low in outdoor conditions, even if it could be more relevant for community indoor environments, in which further studies are necessary to investigate the potential risks. We theoretically examined if atmospheric particles can scavenge virus aerosol, through inertial impact, interception, and Brownian diffusion. The probability was very low. In addition, the probability of coagulation of virus-laden aerosol with pre-existing atmospheric particles resulted negligible for accumulation and coarse mode particles, but virus-laden aerosol could act as sink of ultrafine particles (around 0.01 μm in diameter). However, this will not change significantly the dynamics behaviour of the virus particle or its permanence time in atmosphere.

Analysis of the evolution of the Sars-Cov-2 in Italy, the role of the asymptomatics and the success of Logistic model.

In this article we study the temporal evolution of the pandemic Sars-Cov-2 in Italy by means of dynamic population models. The time window of the available population data is between February 24, and March 25. After we upgrade the data until April 1. We perform the analysis with 4 different models and we think that the best candidate to correctly described the italian situation is a generalized Logistic equation. We use two coupled differential equations that model the evolution of the severe infected and the dead. This choice is due to the fact that in Italy the pharyngeal swabs are made only to severe infected, therefore we have no information about asymptomatic people. Moreover, an important observation is that the virus spreads between Regions with some delay. Indeed, we suggest that a different analysis, region by region, would be more sensible than one on the whole Italy. In particular the region Lombardy has a behaviour very fast compared to the other ones. We show the fit and forecast of the dead and total severe infected for Italy and five regions: Lombardy, Piedmont, Emilia-Romagna, Veneto and Tuscany. Finally we perform an analysis of the peak (intended, in our study, as the maximum of the daily total severe infected) and an estimation of how many lives have been saved by means of the LockDown.

Design teaching and cultural companies: Languages, tools and methods toward a profitable involvement

The topic of this paper is focus on the relationship between design teaching and the different kinds of cultural partners in the field of the cultural design. In this context we mean the company as cultural company. In fact the cultural production is increasingly a lively area of intervention and of business. We assume that it is very important to involve the real interlocutors in the process of design teaching and especially in the field of the cultural design where the complexity of the system is an interesting pretext for to create the useful situations. Specifically we study the relationship between the design disciplines and the humanities sciences as a basis to know the methodologies to enable the contact and the synergies with the cultural institutions (museum, territory communities...). In fact museums, associations, majors, communities of the territories are mainly managed by profiles humanities. The hypothesis is the design teaching programs can be a necessary tool to put innovation in the cultural system (in the specific realities) and (symmetrically) the cultural partners are an important filed of experimentation, but for this target is necessary that design develops the tools and specific modality of dialogue. A demonstration of what will be explained two different experiences of design teaching where the relationship between design and the anthropology culture represent a model of collaboration. The first one regards an intervention (in terms of strategic and exhibit design research) in the Anthropological Museum in Florence; the second one regards a cluster of interpenetrations (in terms of strategic, communication and exhibit de innovasign research) about a cultural identity of the Italian Alpine (partner involved: region Lombardia). In the latter case we work mainly on immaterial cultural heritage (festivals, rituals, gestures, knowledge...)Key words: design and humanities, cultural design, anthropology, rituals, creative ethnography document.

Endowment for Women - Region Lombardia

Endowment for Women - Region Lombardia

Ricercatissimi (top of researches) - Region Lombardia

Ricercatissimi (top of researches) - Region Lombardia

11.1 Cost and Prescription of Antihypertensive Therapy in Region Lombardia Between 2004/2006: Fixed Combinations as Savings Opportunities

11.1 Cost and Prescription of Antihypertensive Therapy in Region Lombardia Between 2004/2006: Fixed Combinations as Savings Opportunities

Microbiological and serological monitoring in hooded crow (Corvus corone cornix) in the Region Lombardia, Italy

The health status of 276 hooded crows (Corvus corone cornix) from various provinces of Lombardy was monitored for three years. Bacteriological examination detected E. coli (76%), Campylobacter jejuni (17%), Salmonella typhimurium (11.6%), Yersinia spp. (6.5%), Clamydophila abortus and C. psittaci (2.6%); from six birds showing severe prostration Pasteurella multocida was isolated. Virological and serological tests were negative for Avian Influenza virus (AIV), West Nile virus (WNV) and only three samples were positive for Newcastle disease virus (NDV) but only at serology (titre 1:16).

Epidemiologia delle batteriemie nosocomiali in Lombardia nel triennio 1999-2001

We analyzed bloodstream infection(BI) performed in eight hospitals in Region Lombardia in the period 1999- 2001 following criteria and methods as in the study performed in the year 1997.Data were evaluated from 434.000 hospital patients (one third of hospital patients annualy recovered in Lombardia Region each year). Of these 56.3 positive blood coltures /1000 patients were observed. Data were similar as 1997. In total 3063 episodes of bacteriemia were observed (6.98 BI / 1000 hospital patients).53% of cases correlated to hospital infection. Organism identification of causative organisms resulted 22.5% for E.coli and 10.6% for KES; 17.7% S.aureus,4.5% Yeast .Anaerobic bacteria resulted involved in 3.4%.Among the frequency of isolates difference was noted in different wards In intensive care unit E.coli was pathogenic in 5.9% of patients, but KES in 25.5% of cases. Differences were noted if nosocomial or comunity infections were involved. It was concluded that epidemiological data of BI from all the hospital of Region Lombardia could support the knowledge of bacteriemic episodes in different wards as useful method of surveillance particularly in order to control economic aspects and efficacy of prevention.