0000000000903748
AUTHOR
Mario Durando
Evaluating the effectiveness and risks of oral anticoagulant treatments in multimorbid frail older subjects with atrial fibrillation using the multidimensional prognostic index
Background: Previous studies suggested that a different risk of mortality may influence the oral anticoagulant prescription in older patients with atrial fibrillation (AF). Recently, the Multidimensional Prognostic Index (MPI) demonstrated a high grade of accuracy, calibration and feasibility to predict mortality in hospitalized and community-dwelling older people. Prognostic information, as calculated by the MPI, however, is not included in the decision algorithm of treatments in older patients with AF Purpose: The aim of this international multicenter prospective observational study was to evaluate whether a different prognostic profile, as determined by the MPI, is associated with differ…
Enteral tube feeding and mortality in hospitalized older patients: A multicenter longitudinal study
Background & aims: The literature regarding enteral nutrition and mortality in older frail people is limited and still conflicting. Moreover, the potential role of comprehensive geriatric assessment is poorly explored. We therefore aimed to investigate whether the Multidimensional Prognostic Index (MPI), an established tool that assesses measures of frailty and predicts mortality, may help physicians in identifying patients in whom ETF (enteral tube feeding) is effective in terms of reduced mortality. Methods: Observational, longitudinal, multicenter study with one year of follow-up. Data regarding ETF were recorded through medical records. A standardized comprehensive geriatric assessm…
FE Calculation Methodology for the Thermodynamic Fatigue Analysis of an Engine Component
Thermo mechanical fatigue problem is treated to define an analysis methodology permitting the strength evaluation by reliability viewpoint. The main difficulty is the lack of both theoretical and experimental information; consequently the problem is treated verifying continually the validity and the limits of the developing solution method. The main task of the activity described in this paper was the development of a numerical methodology, based on FE analyses, for the evaluation of the structural behavior of engine components subjected to thermo mechanical fatigue phenomena. The chosen application was the exhaust manifold of an IC engine; FE analyses were executed following the standard m…
Finite Element Simulation of Multilayer Metal Cylinder Head Gaskets
ABAQUS gasket elements are an efficient and flexible tool to study gasket applications. Nevertheless the usage of the ABAQUS gasket elements is not limited to gasket analysis, but it provides an effective improvement in structural analysis. The results point out that both the predicted contact pressure and the predicted stress distribution depend on the mesh topology. Several combinations of mesh dimension and topology are investigated. The purpose is the definition of a calculation methodology and the demonstration of the application potentiality. Complex models analysis highlights that the set methodology constitutes a very effective tool for the design and optimization of gasket, cylinde…
Drug Prescription and Delirium in Older Inpatients: Results From the Nationwide Multicenter Italian Delirium Day 2015-2016
Objective This study aimed to evaluate the association between polypharmacy and delirium, the association of specific drug categories with delirium, and the differences in drug-delirium association between medical and surgical units and according to dementia diagnosis. Methods Data were collected during 2 waves of Delirium Day, a multicenter delirium prevalence study including patients (aged 65 years or older) admitted to acute and long-term care wards in Italy (2015-2016); in this study, only patients enrolled in acute hospital wards were selected (n = 4,133). Delirium was assessed according to score on the 4 "A's" Test. Prescriptions were classified by main drug categories; polypharmacy w…
"Delirium Day": a nationwide point prevalence study of delirium in older hospitalized patients using an easy standardized diagnostic tool
Background To date, delirium prevalence in adult acute hospital populations has been estimated generally from pooled findings of single-center studies and/or among specific patient populations. Furthermore, the number of participants in these studies has not exceeded a few hundred. To overcome these limitations, we have determined, in a multicenter study, the prevalence of delirium over a single day among a large population of patients admitted to acute and rehabilitation hospital wards in Italy. Methods This is a point prevalence study (called “Delirium Day”) including 1867 older patients (aged 65 years or more) across 108 acute and 12 rehabilitation wards in Italian hospitals. Delirium wa…