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Background. Sepsis is the major cause of mortality from any infectious disease worldwide. Sepsis may be the result of a healthcare associated infection (HAI): the most frequent adverse events during care delivery especially in Intensive Care Units (ICUs). The main aim of the present study was to describe the epidemiology of ICU-acquired sepsis and related outcomes among patients enrolled in the framework of the Italian Nosocomial Infections Surveillance in ICUs - SPIN-UTI project. Study design. Prospective multicenter study. Methods. The SPIN-UTI network adopted the European protocols for patient-based HAI surveillance. Results. During the five editions of the SPIN-UTI project, from 2008 to 2017, 47.0% of HAIs has led to sepsis in 832 patients. Overall, 57.0% episodes were classified as sepsis, 20.5% as severe sepsis and 22.5% as septic shock. The most common isolated microorganisms from sepsis episodes were Acinetobacter baumannii, Klebsiella pneumoniae and Pseudomonas aeruginosa. The case fatality rate increased with the severity of sepsis and the mean length of ICU-stay was significantly higher in patients with ICU-acquired sepsis than in patients without. Conclusions. Our study provides evidence that ICU-acquired sepsis occurs frequently in Italian ICU patients and is associated with a high case fatality rate and increased length of stay. However, in order to explain these findings further analyses are needed in this population of ICU patients.

Background. The circulatory diseases, in particular ischemic heart diseases and stroke, represent the main causes of death worldwide both in high income and in middle and low income countries. Our aim is to provide a comprehensive report to depict the circulatory disease mortality in Europe over the last 30 years and to address the sources of heterogeneity among different countries. Methods. Our study was performed using the WHO statistical information system - mortality database - and was restricted to the 28 countries belonging to the European Union (EU-28). We evaluated gender and age time series of all circulatory disease mortality, ischemic heart diseases, cerebrovascular diseases, pulmonary and other circulatory diseases and than we performed forecast for 2016. Mortality heterogeneity was evaluated by countries using the Cochrane Q statistic and the I-squared index. Results. Between 1985 and 2011 SDR for deaths attributable to all circulatory system diseases decreased from 440.9 to 212.0 x 100,000 in EU-28 and a clear uniform reduction was observed. Heterogeneity among countries was found to be consistent, therefore different analysis were carried out considering geographical area. Conclusions. We forecast a reduction in European cardiovascular mortality. Heterogeneity among countries could only in part be explained by both geographical and health expenditure factors, Introduzione Le malattie del Sistema circolatorio, in particolare la cardiopatia ischemica e l’ictus, rappresentano le principali cause di morte nel mondo, sia nei Paesi ad alto reddito che in quelli a medio e basso reddito. Il nostro obiettivo è quello di fornire un’esaustiva descrizione della mortalità per malattie del sistema circolatorio in Europa negli ultimi 30 anni e di analizzare le fonti di eterogeneità tra i diversi Paesi. Metodi Lo studio, realizzato utilizzando gli indicatori presenti nel database dell’Organizzazione Mondiale della Sanità (OMS), riguarda i 28 Paesi appartenenti all’Unione Europea (EU-28). Sono state valutate le serie temporali della mortalità per età e per genere per tutte le patologie circolatorie, per la cardiopatia ischemica, per le patologie cerebrovascolari, per le patologie vascolari polmonari e altre patologie circolatorie e successivamente è stata effettuata una previsione per l’anno 2016. L’eterogeneità per la mortalità è stata valutata utilizzando il test Q di Cochrane e l’indice I-squared. Risultati Tra il 1985 e il 2011 i tassi standardizzati di mortalità per tutte le patologie del sistema circolatorio si sono ridotti da 440.9 per 100.000 a 212.0 per 100.000 nei 28 Paesi e si osserva un chiaro andamento uniforme. Considerando tutti i Paesi nella stessa analisi, l’eterogeneità è risultata importante e quindi sono state effettuate sottoanalisi raggruppando per area geografica. Conclusioni Dalle analisi effettuate è possibile prevedere una riduzione della mortalità per patologia cardiovascolare in Europa. Inoltre, l’eterogeneità tra i Paesi potrebbe essere parzialmente spiegata sia da fattori geografici che da differenze nella spesa sanitaria

In this work, an investigation of soot-in-oil samples drawn from the oil sump of a gasoline direct injection (GDI) engine was carried out. Soot particulate was characterised in terms of size, distribution and shape of the agglomerates, and internal structure of the primary particles. The test engine was a 1.6 l modern light-duty EURO IV engine operated at speed between 1600 and 3700 rev/min, and torque between 30 and 120 Nm. After a double oil-flushing procedure the engine was operated for 30 h. Oil samples were drawn from the sump and prepared for Transmission Electron Microscopy (TEM) and High resolution TEM analysis (HRTEM) by a combination of solvent extraction, centrifugation and diethyl ether bathing. Soot agglomerates were measured in terms of their skeleton length and width, and fractal dimension. The mean skeleton length and width were 153 nm and 59 nm respectively. The fractal dimension was calculated using an iterative method and the mean value was found to be 1.44. The primary particles were found to be spherical in shape with some irregularities and presented an average diameter of 36 nm with a mode of 32 nm and standard deviation of 13 nm. The majority of particles showed an inner core and outer shell similar to diesel soot, although an amorphous layer was also clearly visible.

In this work, an investigation of soot-in-oil samples drawn from the oil sump of a gasoline direct injection (GDI) engine was carried out. Soot particulate was characterised in terms of size, distribution and shape of the agglomerates, and internal structure of the primary particles. The test engine was a 1.6l modern light-duty EURO IV engine operated at speed between 1600 and 3700rev/min, and torque between 30and120Nm.After a double oil-flushing procedure the engine was operated for 30h. Oil samples were drawn from the sump and prepared for Transmission Electron Microscopy (TEM) and High resolution TEM analysis (HRTEM) by a combination of solvent extraction, centrifugation and diethyl ether bathing. Soot agglomerates were measured in terms of their skeleton length and width, and fractal dimension. The mean skeleton length and width were 153nm and 59nm respectively. The fractal dimension was calculated using an iterative method and the mean value was found to be 1.44. The primary particles were found to be spherical in shape with some irregularities and presented an average diameter of 36nm with a mode of 32nm and standard deviation of 13nm.The majority of particles showed an inner core and outer shell similar to diesel soot, although an amorphous layer was also clearly visible.

In this work, an investigation of soot-in-oil samples drawn from the oil sump of a gasoline direct injection (GDI) engine was carried out. Soot particulate was characterised in terms of size, distribution and shape of the agglomerates, and internal structure of the primary particles. The test engine was a 1.6l modern light-duty EURO IV engine operated at speed between 1600 and 3700rev/min, and torque between 30and120Nm.After a double oil-flushing procedure the engine was operated for 30h. Oil samples were drawn from the sump and prepared for Transmission Electron Microscopy (TEM) and High resolution TEM analysis (HRTEM) by a combination of solvent extraction, centrifugation and diethyl ether bathing. Soot agglomerates were measured in terms of their skeleton length and width, and fractal dimension. The mean skeleton length and width were 153nm and 59nm respectively. The fractal dimension was calculated using an iterative method and the mean value was found to be 1.44. The primary particles were found to be spherical in shape with some irregularities and presented an average diameter of 36nm with a mode of 32nm and standard deviation of 13nm.The majority of particles showed an inner core and outer shell similar to diesel soot, although an amorphous layer was also clearly visible.

In this work, an investigation of soot-in-oil samples drawn from the oil sump of a gasoline direct injection (GDI) engine was carried out. Soot particulate was characterised in terms of size, distribution and shape of the agglomerates, and internal structure of the primary particles. The test engine was a 1.6l modern light-duty EURO IV engine operated at speed between 1600 and 3700rev/min, and torque between 30and120Nm.After a double oil-flushing procedure the engine was operated for 30h. Oil samples were drawn from the sump and prepared for Transmission Electron Microscopy (TEM) and High resolution TEM analysis (HRTEM) by a combination of solvent extraction, centrifugation and diethyl ether bathing. Soot agglomerates were measured in terms of their skeleton length and width, and fractal dimension. The mean skeleton length and width were 153nm and 59nm respectively. The fractal dimension was calculated using an iterative method and the mean value was found to be 1.44. The primary particles were found to be spherical in shape with some irregularities and presented an average diameter of 36nm with a mode of 32nm and standard deviation of 13nm.The majority of particles showed an inner core and outer shell similar to diesel soot, although an amorphous layer was also clearly visible.

In this work, an investigation of soot-in-oil samples drawn from the oil sump of a gasoline direct injection (GDI) engine was carried out. Soot particulate was characterised in terms of size, distribution and shape of the agglomerates, and internal structure of the primary particles. The test engine was a 1.6l modern light-duty EURO IV engine operated at speed between 1600 and 3700rev/min, and torque between 30and120Nm.After a double oil-flushing procedure the engine was operated for 30h. Oil samples were drawn from the sump and prepared for Transmission Electron Microscopy (TEM) and High resolution TEM analysis (HRTEM) by a combination of solvent extraction, centrifugation and diethyl ether bathing. Soot agglomerates were measured in terms of their skeleton length and width, and fractal dimension. The mean skeleton length and width were 153nm and 59nm respectively. The fractal dimension was calculated using an iterative method and the mean value was found to be 1.44. The primary particles were found to be spherical in shape with some irregularities and presented an average diameter of 36nm with a mode of 32nm and standard deviation of 13nm.The majority of particles showed an inner core and outer shell similar to diesel soot, although an amorphous layer was also clearly visible.

In this work, an investigation of soot-in-oil samples drawn from the oil sump of a gasoline direct injection (GDI) engine was carried out. Soot particulate was characterised in terms of size, distribution and shape of the agglomerates, and internal structure of the primary particles. The test engine was a 1.6l modern light-duty EURO IV engine operated at speed between 1600 and 3700rev/min, and torque between 30and120Nm.After a double oil-flushing procedure the engine was operated for 30h. Oil samples were drawn from the sump and prepared for Transmission Electron Microscopy (TEM) and High resolution TEM analysis (HRTEM) by a combination of solvent extraction, centrifugation and diethyl ether bathing. Soot agglomerates were measured in terms of their skeleton length and width, and fractal dimension. The mean skeleton length and width were 153nm and 59nm respectively. The fractal dimension was calculated using an iterative method and the mean value was found to be 1.44. The primary particles were found to be spherical in shape with some irregularities and presented an average diameter of 36nm with a mode of 32nm and standard deviation of 13nm.The majority of particles showed an inner core and outer shell similar to diesel soot, although an amorphous layer was also clearly visible.