A rate-control strategy is the most widely used among elderly AF patients with multiple comorbidities and polypharmacy. No differences were evident in CV death and all-cause death at follow-up.

In this in-hospital cohort, the use of lipid-lowering agents was mainly driven by patients' clinical history, most notably the presence of clinically overt manifestations of atherosclerosis. Increasing age seems to be associated with lower prescription rates. This might be indicative of cautious behavior towards a potentially toxic treatment regimen.

Currently, chronic obstructive pulmonary disease (COPD) represents the fourth cause of death worldwide with significant economic burden. Comorbidities increase in number and severity with age and are identified as important determinants that influence the prognosis. In this observational study, we retrospectively analyzed data collected from the RePoSI register. We aimed to investigate comorbidities and outcomes in a cohort of hospitalized elderly patients with the clinical diagnosis of COPD. Socio-demographic, clinical characteristics and laboratory findings were considered. The association between variables and in-hospital, 3-month and 1-year follow-up were analyzed. Among 4696 in-patients, 932 (19.8%) had a diagnosis of COPD. Patients with COPD had more hospitalization, a significant overt cognitive impairment, a clinically significant disability and more depression in comparison with non-COPD subjects. COPD patients took more drugs, both at admission, in-hospital stay, discharge and 3-month and 1-year follow-up. 14 comorbidities were more frequent in COPD patients. Cerebrovascular disease was an independent predictor of in-hospital mortality. At 3-month follow-up, male sex and hepatic cirrhosis were independently associated with mortality. ICS-LABA therapy was predictor of mortality at in-hospital, 3-month and 1-year follow-up. This analysis showed the severity of impact of COPD and its comorbidities in the real life of internal medicine and geriatric wards.

Hospital acquired infections (HAI) continue to constitute a major health problem for hospital patients. Such a problem is particularly relevant in Intensive Care Wards. Here infections appear to be directly or indirectly related to the patients' death, and the patients, of course, represent a selected group of the most susceptible hosts in the whole hospital due to their immunosuppressed states, underlying diseases and the numerous and highly invasive diagnostic and therapeutic procedures to which they are submitted. This paper reports the results of a one-year surveillance incidence study carried out in four Intensive Care Wards at Padua Hospital by means of a daily visits to the wards and careful collection of the patients' data in a computerized sheet. Two-hundred-thirty-one of the 859 patients considered developed one or more HAI (HAI percentage 26.9%) for a total of 382 HAIs (Infections ratio 44.5%). Nosocomial pneumonias were the most frequent infections detected, whereas urinary tract infections, bacteremias and wound infections were less common in such patients. The study also confirmed the importance of invasive procedures and surgical operations in the predisposition to HAIs. In particular, the importance of the urinary catheter and of tracheal intubation was outlined. In addition, HAI appeared to be related to the duration of hospitalization and to the severity of the patients' illness. HAIs (especially nosocomial pneumonias) were also closely related to the patients' death. Pseudomonas aeruginosa, S. aureus, Acinetobacter and Streptococcus D were the most frequently isolated agents in the infected patients. Gram-negative agents accounted for 57% of all agents isolated and were particularly frequent in both pneumonias and urinary tract infections.(ABSTRACT TRUNCATED AT 250 WORDS)

Statins are a well-recognized cause of a variety of skeletal myopathic effects, which generally resolve when discontinuing the treatment. Among autoimmune manifestations associated with statins, there is immune-mediated necrotizing myopathy (IMNM).The present article summarizes the main features of statin-related IMNM, describing diagnosis, classification, epidemiology, treatment, and the main autoantibodies detected.Statins are a well-recognized cause of a variety of skeletal myopathic effects, which generally resolve when discontinuing the treatment. Among autoimmune manifestations associated with statins, there is immune-mediated necrotizing myopathy (IMNM).The present article summarizes the main features of statin-related IMNM, describing diagnosis, classification, epidemiology, treatment, and the main autoantibodies detected.Although it is impossible to define the precise number, it evident that more than 550 statin-related IMNM cases have been described in the literature. Among IMNM, two forms must be distinguished: with anti-3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR) and with anti-signal recognition particle (SRP) antibodies. The differential diagnosis should be made between the IMNM and self-limited statin-related myopathy, drug-induced rhabdomyolysis, and nonautoimmune myopathies.Patients who have failed to normalize high creatine phosphokinase (CPK) after statin withdrawal should be tested for anti-HMGCR antibodies and, if these are positive, undergo muscle biopsy to confirm the diagnosis of IMNM. Pharmacological therapy of IMNM, not yet based on evidence, involves the use of high-dose corticosteroids, immunosuppressant drugs used alone or in combination, intravenous immunoglobulins (IVIg) or plasmapheresis.