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Background: Intracellular calcium is essential for muscle cells contrac- tion. Several drugs such as amines and levosimendan increase inotropism by acting directly or indirectly on intracellular calcium levels or sensitiv- ity. Serum calcium levels (SCL) are not directly correlated to intracellular calcium concentration, but a reduced gradient could influence intracellular concentrations. For this reason, we aimed to evaluate whether SCL could be related to in-hospital survival among patients affected by acute heart failure. Materials and Methods: 216 consecutive patients admitted to our Internal Medicine Department (IMD) for acute heart failure were retrospectively enrolled. In-hospital mortality and comorbidities (hypertension, diabetes, atrial fibrillation, chronic heart failure, acute coronary syndrome, COPD, sepsis, chronic kidney disease and cancer) were collected as binary vari- ables. Days of hospitalization were treated as continuous data. SCL were synthesized as an ordinal variable (25% low percentile, 50% middle percen- tile and 25% high percentile).Cox regression model was set up to evaluate the role of serum calcium levels on in-hospital mortality inserting in the model all the comorbidities, days of hospitalization, age and sex as covari- ates. Statistic was performed with SPSS 13.0 for Windows Systems. Results: Mean age was 80 years (±12,55 years), with M:F ratio of 1:1 (males 52.7%). Diabetes was present in 23,1%, hypertension in 34,3%, ac- tive cancer in 8,8%, atrial fibrillation in 30,1%, chronic ischemic cardiopa- thy in 28,2%, acute coronary syndrome in 12,5%, congestive heart failure in 42,6%, COPD in 18,1%, sepsis in 1,4%, chronic kidney disease in 18,5% of the sample. 13,4% of the sample died during the admission. Mean of the days of hospitalization was of 12,65 days (±8,28 days). In the Cox model, correcting for all the above-mentioned covariates, serum calcium levels taken at the admission behaved as an independent risk factor for in-hospital death (Figure 1). Lower or normal serum calcium levels were associated to a higher risk of in-hospital mortality (OR: 8,308; 95%CI:1,075-64,21; p

Introduction: The Sequential Organ Failure Assessment (SOFA) Score is a score validated to assess prognosis in septic patients. The initial SOFA score predicts in-hospital mortality: values above 11 are correlated with a mortal- ity more than 80%. Troponin I (TnI) is a marker of myocardial injury, but its role in sepsis is still controversial: it has been supposed that TnI could iden- tify patients with a worse prognosis. We aimed to evaluate if adding TnI to SOFA score resulted in a better prognostic performance in the septic patient. Materials and Methods: 81 patients affected by severe sepsis or septic shock and admitted to our Internal Medicine Department were enrolled. For each patient, SOFA score and serum TnI, procalcitonin (PCT), C-reactive protein (CRP) were evaluated at the admission. Outcome was defined as in-hospital death, and collected as a binary variable. TnI was recorded both as a continuous and as a dichotomous variable (≤0.05 or >0.05 ng/ml). Age and days of in-hospital admission were collected as continuous variables. Sex was treated as dichotomous. SOFA score was synthesized as an ordi- nal variable, considering partial pressure of oxygen, fraction of inhaled O2, platelet count, Glasgow coma scale, serum bilirubin and creatinine and the degree of hypotension (1) as single items of the scale. SOFA-T was calcu- lated adding 1 point to SOFA score if TnI levels were higher than 0.05 ng/ ml. The difference in levels of TnI between survivors and non survivors was analyzed with a Univariate/GLM including SOFA, CRP, PCT, age, sex and days of admission as covariates. ROC curve analysis was performed considering SOFA and SOFA-T to predict the main outcome. Analysis was performed with SPSS 13.0 for Windows systems. Results: Mean age was 77,7±11,24 years, males representing 53,8% of the sample. 33,8% of the patients died during the hospitalization. Mean SO- FA score was 6,42±3,24. The mean days of admission were 16,07±10,25. TnI had a mean concentration of 2,31±7,14 ng/ml, PCT 11,51±21,33 pg/ ml, CRP 14,96±11,1 mg/dl. At univariate/GLM model estimated mean TnI level was 1,028 ng/ml (SE: 0,722) among survivors, while it was 4,779 ng/ ml (SE:1,243) among non survivors, and this difference was statistically Figure 1. ROC curve analysis in predicting in-hospital death for patients with sepsis with SOFA or SOFA-T score significant (p

Background: Seric uric acid (SUA) is the final product of purine metabo- lism, known as the cause of gout and uratic nephropaty. In the last decades many studies have been performed to investigate its role as a cardio-vascu- lar risk factor and today literature defines SUA as a controversial protective antioxidant resource against cardiovascular diseases that seems to lose this role both in case of lower SUA levels and in hyperuricemia, when antioxi- dant activity is imbalanced into the field of oxidant injury. Methods: We retrospectively collected data from 651 patients with acute stroke followed during the period between 2011 and 2013. Mean age of the sample was 79 years, males represented 47,6%; patients affected by chronic kidney disease were 47.5%. Results: The duration of hospitalization for acute stroke, when related to SUA levels, showed a J-curve distribution, with longer admissions observed among patients with both lower (7 mg/dl) SUA levels (Fig.1). Kaplan-Meier’s curve showed that patients with levels between 4.5 and 7.0 mg/dl had a significantly better in-hospital survival than patients with low SUA levels ( 7 mg/dl), as shown in Fig.2 (p