Search

Background: Few studies have reported a double-step follow-up of patients after hospitalization for COVID-19. Objectives: We designed an observational double-step follow-up study with a clinical, functional, and radiological evaluation at 2 and 6 months after COVID-19. The primary outcome was to describe symptoms, spirometry, and 6-minute walking test (6MWT) at 2 and 6 months. Secondary outcomes were to identify if the lowest PaO2/FiO2 during hospitalization is related with functional and radiological evolution and to assess the correlation between radiological and functional abnormalities at 6 months. Methods: Symptoms, spirometry, and 6MWT were assessed at 2 and 6 months; arterial blood gas, chest x-ray, and lung ultrasound were performed at 2 months; body plethysmography, diffusing capacity for carbon monoxide (DLCO), and CT scan were performed at 6 months. Results: Sixty-four per cent and 42% of patients reported at least one symptom at 2 and 6 months, respectively. The most common 6-month functional alteration was DLCO impairment (57% of patients). An improvement of FEV1, FVC, and 6MWT was observed between 2 and 6 months (p < 0.001). Patients with PaO2/FiO2 p < 0.05) and reported more extended radiological abnormalities at 6 months (p < 0.001) compared with patients with PaO2/FiO2>200. At 6 months, more extended radiological abnormalities were related with worse 6MWT, DLCO, and total lung capacity (p < 0.05). Discussion: DLCO and 6MWT impairment seem to be the functional hallmark of COVID-19 and are related with the severity of acute pneumonia. At 6 months, radiological abnormalities were related to functional impairment.

We report the longest follow-up of clinical and biochemical features of two previously reported adult mitochondrial neurogastrointestinal encephalomyopathy (MNGIE) patients treated with liver transplantation (LT), adding information on a third, recently transplanted, patient. All three patients overcame the early post-operative period and tolerated immunosuppressive therapy. Plasma nucleoside levels dramatically decreased, with evidence of clinical improvement of ambulation and neuropathy. Conversely, other features of MNGIE, as gastrointestinal dysmotility, low weight, ophthalmoparesis, and leukoencephalopathy were essentially unchanged. A similar picture characterized two patients treated with allogenic hematopoietic stem cell transplantation (AHSCT). In conclusion, LT promptly and stably normalizes nucleoside imbalance in MNGIE, stabilizing or improving some clinical parameters with marginal periprocedural mortality rate as compared to AHSCT. Nevertheless, restoring thymidine phosphorylase (TP) activity, achieved by both LT and AHSCT, does not allow a full clinical recovery, probably due to consolidated cellular damage and/or incomplete enzymatic tissue replacement.

In the last decades the scientific community has increasingly used satellite Synthetic Aperture Radar (SAR) data to improve the understanding of geophysics phenomena in many fields (e.g. geology, hydrology, glaciology, climatology, volcanology) as well as in civilian and environmental engineering. In this context, an additional step forward was provided by the new generation of X-Band very high-resolution SAR sensors, such as those hosted onboard the Italian COSMO-SkyMed (CSK) satellites, able to provide an exceptional capability of collecting dense interferometric data stacks in a short time interval (i.e. few months) with a resolution allowing to monitor single facilities in detail. In many case studies, the available CSK historical series of displacements highlighted the presence of localized deformation points, for example affecting cultural heritage buildings or of potential concern for the stability of bridges and railway networks. This highlights the maturity achieved by this technology widely used also by municipalities and public bodies for monitoring structures and infrastructures. Since 2008, ASI has strongly supported the exploitation of this kind of satellite data and in 2015, following the previous successful experiences, decided to encourage the international scientific community and the national Small and Medium Enterprises (SMEs) through two dedicated “COSMO-SkyMed Open Call” initiatives. In this framework, this paper presents some selected case studies for structure and infrastructure monitoring and the related results, focusing the discussion on the recent developments and observed trends for both scientific and commercial communities, at both national and international levels.

Over the past few years, ASI has devoted great attention to the development of technologies and strengthening of the supply chain aimed particularly at areas of excellence and the development of systems skills innovative. In the field of technologies, it supports initiatives dedicated to low TRL technologies (Technology Readiness Level), high TRL and In Orbit Validation (IOV - trend under development also at EU level in Horizon 2020 program) through national investment lines coordinated with the intervention in optional ESA programs and with the aforementioned H2020. With regard to system capabilities, there are several development initiatives dedicated to prototype and innovative programs in national excellence sectors, such as remote earth sensing; in particular, for SAR systems, is worth mentioning the launch of the first satellite of the second Generation of COSMO-SkyMed and, in the Hyperspectral field, the launch of the PRISMA satellite. Meanwhile there are a number of new developments related to the evolution of such systems, including also to the development of new capabilitiesthroughthe Small Satellites product line. In this paper an overview of the ASI roadmap in technology and programs for remote sensing is provided.

PRISMA, in orbit since March the 22nd 2019, opened the user access in spring 2020. After one year, many hundreds of users have gained the capability to program new acquisitions or download image products from the online archive containing more than 67k datasets, under a quasi-open & free data policy and licensing scheme. During this time frame and despite the COVID-19 related difficulties, PRISMA performed normal operations delivering not only nominal verified quality data to users but establishing collaborations with other space agencies, in order to enable and support synergies with other hyperspectral missions. This paper describes the mission and the results achieved in this first period of full operational usage.

In this work we performed a comparison between two different approaches to track a person in indoor environments using a locating system based on BLE technology with a smartphone and a smartwatch as monitoring devices. To do so, we provide the system architecture we designed and describe how the different elements of the proposed system interact with each other. Moreover, we have evaluated the system’s performance by computing the mean percentage error in the detection of the indoor position. Finally, we present a novel location prediction system based on neural embeddings, and a soft-attention mechanism, which is able to predict user’s next location with 67% accuracy.

n.a.

In intelligent environments, one of the most common available input data is location. It can be easily captured with little additional infrastructure thanks to the ever-present smartphones or smartwatches that enable new opportunities and services in the field of pervasive computing and sensing. However, in some cases, such as in an elderly care context, it is useful to infer additional information, such as identifying unusual activities or abnormal behaviors of monitored users. In this paper, a system that uses location data to infer additional semantic information about a user's behavior is presented. The semantic location data can then be transformed into behavioral indicators that can be used to analyze the user's activities. In order to infer user activities, the proposed system requires a minimal infrastructure.

In this paper advanced neural networks (NNs) based techniques are presented to detect and classify changes in multi-temporal SAR COSMO-SkyMed images. The core and more innovative algorithm of the methodology is based on PCNNs (Pulse Couple Neural Networks), which perform the change detection task, while a standard Multi-Layer Perceptron (MLP) topology is considered to identify the type of changes occurred. The paper aims at providing a complete automatic processing chain usable also for extended areas. In fact, the PCNNs, being unsupervised networks, are inherently automatic. On the other hand, MLPs, which are supervised networks, are assumed to be learned off-line and plugged into the workflow without further training. The experimental results, which have been obtained over various urban areas in the city of Rome, are encouraging and confirm the validity of the considered approach.

In this preliminary physiological study, we have shown that in patients with COPD who are recovering from an acute exacerbation, the recording of PEEPi using ultrasound and P0.1 measurements is both feasible and reliable, and yields values comparable to those obtained by the more invasive gold standard technique. Further studies are needed to validate this technique on a larger scale with a wider range of PEEPi values

The Constellation of Small Satellites for the Mediterranean Basin Observation (COSMO)-SkyMed Second Generation (CSG) ground segment (GS) is based on an interoperable and multimission design that provides CSG functionalities to external partners and access through the CSG to services belonging to other Earth observation (EO) partners. Moreover, the CSG GS design supports such cooperation by expansion through replication of user GSs (UGSs) in different ways. In this manner, the CSG GS is able to manage EO foreign missions by providing centralized and multimission access in an integrated environment, thus offering valuable technological solutions to the defense and civilian communities. This article provides an indepth description of the CSG system access portfolio, focusing on the architectural details of the GS that allow the provisioning and exploitation of the CSG's interoperability, expandability, and multisensor/multimission (IEM) features.

In intelligent environments one of the most relevant information that can be gathered about users is their location. Their position can be easily captured without the need for a large infrastructure through devices such as smartphones or smartwatches that we easily carry around in our daily life, providing new opportunities and services in the field of pervasive computing and sensing. Location data can be very useful to infer additional information in some cases such as elderly or sick care, where inferring additional information such as the activities or types of activities they perform can provide daily indicators about their behavior and habits. To do so, we present a system able to infer user activities in indoor and outdoor environments using Global Positioning System (GPS) data together with open data sources such as OpenStreetMaps (OSM) to analyse the user’s daily activities, requiring a minimal infrastructure.

Background Persistent hypercapnia after COPD exacerbation is associated with excess mortality and early rehospitalization. High Flow Nasal cannula (HFNC), may be theoretically an alternative to long-term noninvasive ventilation (NIV), since physiological studies have shown a reduction in PaCO2 level after few hours of treatment. In this clinical study we assessed the acceptability of HFNC and its effectiveness in reducing the level of PaCO2 in patients recovering from an Acute Hypercapnic Respiratory Failure (AHRF) episode. We also hypothesized that the response in CO2 clearance is dependent on baseline level of hypercapnia. Methods Fifty COPD patients recovering from an acute exacerbation and with persistent hypercapnia, despite having attained a stable pH (i.e. pH > 7,35 and PaCO2 > 45 mmHg on 3 consecutive measurements), were enrolled and treated with HFNC for at least 8 h/day and during the nighttime Results HFNC was well tolerated with a global tolerance score of 4.0 ± 0.9. When patients were separated into groups with or without COPD/OSA overlap syndrome, the “pure” COPD patients showed a statistically significant response in terms of PaCO2 decrease (p = 0.044). In addition, the subset of patients with a lower pH at enrolment were those who responded best in terms of CO2 clearance (score test for trend of odds, p = 0.0038). Conclusions HFNC is able to significantly decrease the level of PaCO2 after 72 h only in “pure” COPD patients, recovering from AHRF. No effects in terms of CO2 reduction were found in those with overlap syndrome. The present findings will help guide selection of the best target population and allow a sample size calculation for future long-term randomized control trials of HFNC vs NIV. Trial registration This study is registered with www. clinicaltrials.gov with identifier number NCT03759457.

Recently, most solutions designed for Ambient Assisting Living systems are based on indoor positioning systems. There are several technologies and approaches to develop indoor tracking and positioning with different advantages and shortcomings. Taking into account as a starting point some limits and issues analyzed in related scientific works focused on smart AAL systems able to improve the life quality of elderly people, this work aims to carry out a performance comparison between two different approaches to track a person in indoor environments. Both a smartphone and a wearable device have been used in our tests, analyzing the differences of each approach.

Synthetic Aperture Radar (SAR) images taken over a certain area at different bands and also with a short time interval are now more widely available. This is due to the increase of SAR acquisitions following the last space missions, such as Sentinel 1 and COSMO-SkyMed (CSK). New paradigms capable of performing effective analysis and synthesis stemming from such a type of information are then required in order to exploit better and disseminate the information contained in the data. In this letter, a data fusion technique between CSK and Sentinel-1 data is described. To this purpose, an ad hoc Nonlinear Principal Component Analysis (NLPCA) with Auto-Associative Neural Networks (AANNs) algorithm is designed and developed. The network extracts the most relevant features from the combination of the different scattering mechanisms. The extracted features are then used as inputs for a land cover classification exercise. A comparison between the results obtained with the original images and those yielded by the new synthesized data, with lower dimensionality, demonstrates the ability of the algorithm to generate useful final products.

Interfaces are an important issue in treating patients with acute hypercapnic respiratory failure (AHRF) and advances have been made in the development of masks able to reduce rebreathing of exhaled carbon dioxide (CO2). We designed a randomized, crossover, physiological study to compare two configurations of a full face mask in terms of effectiveness (Arterial Blood Gases (ABGs) and respiratory rate (RR)) and comfort. Patients recovering from an AHRF episode were randomized to receive 1 hour trial with NIV using the same mask (DiMax®, DIMAR, Medolla, Italy) with two different configurations: the “standard one” with a single inlet and outlet (sDiMax) vs the same interface with a double inlet and outlet connection (DiMax Zero). A wash out period was allowed between the trials to obtain a value of PaCO2 not varying > 5 mmHg from the previous baseline. 9 COPD consecutive patients were studied. Baseline ABGs and RR were not different between the trials (i.e. PaCO2 71.3+8 mmHg vs 69+11 mmHg and 24.7+4 bpm vs 23.7+3.1 bpm, for sDiMax and DiMax Zero, respectively). After 1 hour of NIV, DiMax Zero was more effective than sDiMax in reducing PaCO2 (59.7+5.7 mmHg vs 64.7+12 mmHg p=0.02), while pH and PaO2 did not vary significantly. RR was significantly reduced with both mask settings, and patient’s comfort and tolerance were good and similar in both groups. The preliminary results of this crossover randomized trial showed that DiMax Zero was able to significantly reduce PaCO2 vs the sDiMax setting, while both configurations significantly reduced RR with similar patient’s comfort.

Introduction: Multiple organ failure has been considered a contraindication for noninvasive ventilation (NIV). Materials and methods: We described the outcome of Do-not-Intubate (DNI) patients with acute respiratory failure, treated with NIV and, subsequently, necessitating renal replacement therapy (RRT). Results and discussion: Seven patients admitted to our Respiratory Intensive Care Unit, developed Acute Kidney Injury (AKI) during NIV treatment and received RRT for 12.8±8 days together with NIV. All the patients but one, discontinued renal support because they regained a satisfactory urinary output; nevertheless mortality rate was high (71%). Conclusion: Our data suggest that RRT could be feasible together with NIV. RRT was associated with an acute improvement in renal function but did not modify the mortality rate.

COSMO-SkyMed di Seconda Generazione (CSG) will ensure operational continuity to the currently operating "first generation" CSK constellation. The CSG constellation will consist of two satellites in Low Earth Orbit equipped with an X-band Synthetic Aperture Radar (SAR). The CSG program is managed and co-financed by the Italian Space Agency (ASI) and the Italian Ministry of Defence. A wider portfolio of Spotlight imaging modes is offered with respect to CSK, among which there are new Spotlight civilian sub-metric modes. Furthermore, products acquired with squinted attitude (i.e. mean pitch angle during the acquisition different by zero) or with multi-swath approach could be used to serve more requests in a defined area, that otherwise could not be served because of conflict for time gap violation. Upgraded Spotlight focusing algorithms have been developed in order to correctly manage side-effects on the SAR Impulse Response Function (IRF) image quality depending on the long integration time and squinted geometry. The paper presents the new Spotlight processing algorithm enhancements providing details about design, implementation and verification results. Image quality and processor time performances have been assessed by simulated data representative of the various operational Spotlight CSG acquisition modes.

We studied the effects of high flow oxygen therapy (HFOT) versus non-invasive ventilation (NIV) on inspiratory effort, as assessed by measuring transdiaphragmatic pressure, breathing pattern and gas exchange. Fourteen patients with hypercapnic COPD underwent five 30-min trials: HFOT at two flow rates, both with open and closed mouth, and NIV, applied in random order. After each trial standard oxygen therapy was reinstituted for 10â €..min. Compared with baseline, HFOT and NIV significantly improved breathing pattern, although to different extents, and reduced inspiratory effort; however, arterial carbon dioxide oxygen tension decreased but not significantly. These results indicate a possible role for HFOT in the long-Term management of patients with stable hypercapnic COPD. Trial registration number NCT02363920.

Objectives: To assess efficacy and safety of noninvasive ventilation-plus-extracorporeal Co2 removal in comparison to noninvasive ventilation-only to prevent endotracheal intubation patients with acute hypercapnic respiratory failure at risk of failing noninvasive ventilation. Design: Matched cohort study with historical control. Setting: Two academic Italian ICUs. Patients: Patients treated with noninvasive ventilation for acute hypercapnic respiratory failure due to exacerbation of chronic obstructive pulmonary disease (May 2011 to November 2013). Interventions: Extracorporeal CO2 removal was added to noninvasive ventilation when noninvasive ventilation was at risk of failure (arterial pH ≤ 7.30 with arterial PCO2 > 20% of baseline, and respiratory rate ≥ 30 breaths/min or use of accessory muscles/paradoxical abdominal movements). The noninvasive ventilation-only group was created applying the genetic matching technique (GenMatch) on a dataset including patients enrolled in two previous studies. Exclusion criteria for both groups were mean arterial pressure less than 60 mm Hg, contraindications to anticoagulation, body weight greater than 120 kg, contraindication to continuation of active treatment, and failure to obtain consent. Measurements and Main Results: Primary endpoint was the cumulative prevalence of endotracheal intubation. Twenty-five patients were included in the noninvasive ventilation-plus-extracorporeal CO2 removal group. The GenMatch identified 21 patients for the noninvasive ventilation-only group. Risk of being intubated was three times higher in patients treated with noninvasive ventilation-only than in patients treated with noninvasive ventilation-plus-extracorporeal CO2 removal (hazard ratio, 0.27; 95% CI, 0.07–0.98; p = 0.047). Intubation rate in noninvasive ventilation-plus-extracorporeal CO2 removal was 12% (95% CI, 2.5–31.2) and in noninvasive ventilation-only was 33% (95% CI, 14.6–57.0), but the difference was not statistically different (p = 0.1495). Thirteen patients (52%) experienced adverse events related to extracorporeal CO2 removal. Bleeding episodes were observed in three patients, and one patient experienced vein perforation. Malfunctioning of the system caused all other adverse events. Conclusions: These data provide the rationale for future randomized clinical trials that are required to validate extracorporeal CO2 removal in patients with hypercapnic respiratory failure and respiratory acidosis nonresponsive to noninvasive ventilation.

Imaging plays a key role in the diagnosis and follow-up of acute respiratory distress syndrome (ARDS). Chest radiography, bedside lung ultrasonography and computed tomography scans can provide useful information for the management of patients and detection of prognostic factors. However, imaging findings are not specific and several possible differential diagnoses should be taken into account. Herein we will review the role of radiological techniques in ARDS, highlight the plain radiological and computed tomography findings according to the pathological stage of the disease (exudative, inflammatory and fibroproliferative), and summarise the main points for the differential diagnosis with cardiogenic oedema, which is still challenging in the acute stage.

BACKGROUND: The outcomes of patients admitted to a respiratory ICU (RICU) have been evaluated in the past, but no study has considered the influence of location prior to RICU admission. METHODS: We analyzed prospectively collected data from 326 consecutive patients admitted to a 7-bed RICU. The primary end points were survival and severity of morbidity-related complications, evaluated according to the patient's location prior to RICU admission. Three admission pathways were considered: step-down for patients transferred from the ICUs of our hospital; step-up for patients coming from our respiratory wards or other medical wards; and directly for patients coming from the emergency department. The secondary end point was the potential influence of several risk factors for morbidity and mortality. RESULTS: Of the 326 subjects, 92 (28%) died. Overall, subjects admitted in a step-up process had a significantly higher mortality ( P < .001) than subjects in the other groups. The mortality rate was 64% for subjects admitted from respiratory ward, 43% for those from medical wards, and 18% for subjects from both ICU and emergency department (respiratory ward vs medical ward P = .04, respiratory ward vs emergency department P < .001, respiratory ward vs ICU P < .001, medical ward vs emergency department P < .001, and medical ward vs ICU P < .001). Subjects admitted from a respiratory ward had a lower albumin level, and Simplified Acute Physiology Score II was significantly higher in subjects following a step-up admission. About 30% of the subjects admitted from a respiratory ward received noninvasive ventilation as a “ceiling treatment.” The highest odds ratios related to survival were subject location prior to RICU admission and female sex. Lack of use of noninvasive ventilation, younger age, female sex, higher albumin level, lower Simplified Acute Physiology Score II, higher Barthel score, and absence of chronic heart failure were also statistically associated with a lower risk of death. CONCLUSIONS: The pathway of admission to a RICU is a determinant of outcome. Patients following a step-up pattern are more likely to die. Other major determinants of survival are age, nutritional status and female sex.

PURPOSE: This study aimed to prospectively investigate F-FDG PET/CT role for the assessment of sarcoidosis activity and extension in comparison with thoracic high-resolution CT (HRCT) and to evaluate the potential clinical impact of PET/CT findings. Secondary aim was to investigate the changes in cardiac FDG uptake related to the specific preparation before PET/CT. METHODS: We prospectively enrolled biopsy proven sarcoidosis patients consecutively referred for F-FDG PET/CT since January 2010. PET/CT was performed after a fat meal followed by 12-hour fasting and compared with thoracic HRCT results obtained in supine position and clinical follow-up. The impact on the clinical management was recorded.Patterns of cardiac FDG uptake of the study group were compared with a historical population in which PET/CT was performed following standard preparation. RESULTS: A total of 28 patients were enrolled, and 35 PET/CT scans were reviewed. On a scan basis, PET/CT was concordant with HRCT in 16 (45.7%), detecting active disease in 10/16 and no signs of activity in 4/16. PET/CT data had a direct impact on management in 4/16.In 19 (54.3%) discordant scans, PET/CT finding was positive in 14 and negative in 5. PET/CT findings influenced the clinical management in 18/19 cases.Considering all scans, PET/CT information influenced the clinical management of 22 (63%) of 35.Our data suggest that cardiac FDG uptake may vary regardless of the preparation before PET/CT. CONCLUSIONS: F-FDG PET/CT was useful to assess sarcoidosis activity and extension and provided valuable information for the clinical management in a single-step examination. Additional data are needed to better ascertain the optimal patient preparation before image acquisition to improve sensitivity of heart lesions.

Letter to the Editor

The detection of intrinsic Positive End-Expiratory Pressure (PEEPi) is one of the main clinical challenge in patients with COPD, since it requires the insertion of gastro-esophageal balloons, to record the changes of transdiaphragmatic pressure (PdiPEEPi) and flow. In this study we aimed to record the PEEPi, using a noninvasive method, comparing it with PdiPEEPi. We recorded a total of 84 measures in 7 COPD patients recovering from an episode of acute hypercapnic respiratory failure requiring mechanical ventilation. In the first part of the study we tested the hypothesys that subtle change from linear to granular pattern of diaphragm-liver interface, during M-mode echography was due to the start of diaphragm contraction. When compared to the start of the Pdi rise (i.e.indication of beginning of diaphragm contraction) the difference between the two we recording was 2.5+1.3 ms. Subsequently we measured with the echographyc method the presence of PEEPi (echoPEEPI) using the following equation: echo PEEPi= P0.1 x T lat /100 where P0.1=mouth occlusion pressure at 100ms,T lat = echography time latency between diaphragm contraction and onset of inspiratory flow. P0.1 was used for measuring the slope of the pressure signal to estimate the effort the patients must overcome to generate inspiratory flow. The Bland and Altman plot showed a bias of only -0,3 cmH20, between PdiPEEPi and ecoPEEPi, with estimated limits of agreement +1.1 and -1.6 cmH20 and a high interoperator concordance (interclass correlation coefficient=0.98, CI95% 0.97-0.99). We described for the first time the good agreement between an invasive recording of PEEPi and a noninvasive one.

The generation of Interferometric Spotlight DEMs is investigated, using the processing chain included in the Delft Object-oriented Radar Interferometric Software (DORIS [1]). The effects of not correctly handled Doppler drift is shown. The standard interferometric processing, without Doppler drift handling, has been applied to Spotlight image pairs, showing the interferometric coherence loss occurring as we move away from scene center. Then, the proper interferometric processing for Spotlight data has been applied obtaining very high resolution and accuracy DEMs. Some Spotlight image pairs have been processed and the obtained DEMs have been shown and analyzed proving the high details and product accuracy.

COSMO-SkyMed is a constellation of four radar satellites for Earth Observation (EO), funded by the Italian Ministry of Research and Italian Ministry of Defence (I-MoD) and conducted by the Italian Space Agency (ASI) in conjunction with I-MoD. It has been entirely designed, developed and produced in Italy. Thanks to the realization of this system, one of the most challenging space-borne imaging radar system designed and built in Europe, Italy is playing a key role in the international context. This dual-use space system, capable of the highest operational capability in the world (mainly thanks to its four satellites, high revisit and response time, high resolution), was conceived to serve a wide EO community, proving high-definition data in all-time (day/night) and all-weather conditions to institutions, defense organizations and private companies. Currently, all the four satellites have completed their nominal operational life (5.25 years), but the constellation is still fully operative, provides data with the required image quality and today the expected residual lifetime is of more than one year also for the older satellite (more years for the most recent ones). This paper is focused on all the strategies and measures applied to increase this operational lifetime.

Interstitial lung diseases include different clinical entities with variable prognoses. Idiopathic pulmonary fibrosis (IPF), the most common, presents the most severe outcome (death within 3–5 y), whereas nonspecific interstitial pneumonia (NSIP) shows a more indolent progression. Preclinical evidence of somatostatin receptor (SSTR) expression on fibroblasts in vitro and in lung fibrosis murine models, coupled with the longer survival of mice with fibrotic lungs treated with agents blocking SSTR, supports the hypothesis of imaging fibroblast activity in vivo by visualization of SSTR with 68Ga-DOTANOC PET/CT. The aim of this study was to evaluate 68Ga-DOTANOC PET/CT in patients with IPF and NSIP. Methods: Seven IPF patients and 7 NSIP patients were included in the study. 68Ga-DOTANOC PET/CT and high-resolution CT (HRCT) were performed in all cases by following a standard procedure. PET/CT results were compared with disease sites and extent on HRCT. Results: In IPF, 68Ga-DOTANOC uptake was peripheral, subpleural, and directly correlated with pathologic areas on HRCT (subpleural/reticular fibrosis, honeycombing). NSIP patients showed fainter tracer uptake, whereas corresponding HRCT showed areas of ground-glass opacity and rare fibrotic changes. Only IPF patients showed a linear correlation between maximal SUV and disease extent quantified both automatically (Q) (IPF: P = 0.002, R = 0.93) and using the visual score (Spearman ρ = 0.46, P = 0.0001). Q directly correlated with percentage carbon monoxide diffusing capacity in IPF (P = 0.03, R = 0.79) and NSIP (P = 0.05, R = 0.94), whereas maximal SUV did not present any correlation with percentage carbon monoxide diffusing capacity. Conclusion: Our preliminary data show that 68Ga-DOTANOC PET/CT demonstrates SSTR overexpression in IPF patients; this may prove interesting for the evaluation of novel treatments with somatostatin analogs.

The aim of this study was to determine the prevalence of airway malacia and its relationship with ancillary morphologic features in patients with chronic obstructive pulmonary disease (COPD). A retrospective review was performed of a consecutive series of patients with COPD who were imaged with inspiratory and dynamic expiratory multidetector computed tomography (MDCT). Airway malacia was defined as > or =50% expiratory reduction of the airway lumen. Both distribution and morphology of airway malacia were assessed. The extent of emphysema, extent of bronchiectasis and severity of bronchial wall thickness were quantified. The final study cohort was comprised of 71 patients. Airway malacia was seen in 38 of 71 patients (53%), and such proportion was roughly maintained in each stage of COPD severity. Almost all tracheomalacia cases (23/25, 92%) were characterised by an expiratory anterior bowing of the posterior membranous wall. Both emphysema and bronchiectasis extent did not differ between patients with and without airway malacia (p > 0.05). Bronchial wall thickness severity was significantly higher in patients with airway malacia and correlated with the degree of maximal bronchial collapse (p < 0.05). In conclusion, we demonstrated a strong association between airway malacia and COPD, disclosing a significant relationship with bronchial wall thickening.

COSMO-SkyMed (CSK), is an Earth Observation joint program between Agenzia Spaziale Italiana (Italian Space Agency, ASI) and Italian Ministry of Defense (It-MoD). It consists of a constellation of four X Band Synthetic Aperture Radar (SAR) whose first satellite of has been launched on June 2007. Today the full constellation is fully qualified and is in an operative phase. The COSMO-SkyMed System includes 3 Segments: the Space Segment, the Ground Segment and the Integrated Logistic Support and Operations Segment (ILS and OPS) As part of a more complex re-engineering process aimed to improve the expected constellation lifetime, to fully exploit several system capabilities, to manage the obsolescence, to reduce the maintenance costs and to exploit the entire constellation capability for Civilian users a series of activities have been performed. In the next months these activities are planned to be completed and start to be operational so that it will be possible the programming, planning, acquisition, raw processing and archiving of all the images that the constellation can acquire.