Can healthcare utilization data reliably capture cases of chronic respiratory diseases? a cross-sectional investigation in Italy

Healthcare utilization data are increasingly used for chronic disease surveillance. Nevertheless, no standard criteria for estimating prevalence of high-impact diseases, such as chronic obstructive pulmonary disease (COPD) and asthma, are available. In this study an algorithm for recognizing COPD/asthma cases from HCU data is developed and implemented in the HCU databases of the Italian Lombardy Region (about 10 million residents). The impact of diagnostic misclassification for reliably estimating prevalence was also assessed

Adorare caelestia, gubernare terrena

Il volume raccoglie i saggi di venticinque studiosi che hanno inteso rendere omaggio a Paolo Lucentini

Adorare caelestia, gubernare terrena

Il volume raccoglie i saggi di venticinque studiosi che hanno inteso rendere omaggio a Paolo Lucentini

Zebrafish larvae: A new model to study behavioural effects and metabolism of fentanyl, in comparison to a traditional mice model

In an effort to find alternatives to study in vivo the so-called New Psychoactive Substances (NPS), the present work was undertaken to investigate the use of zebrafish larvae as animal model in pharmaco-toxicology, providing behavioural and metabolism information. For this purpose, fentanyl, the progenitor of an extremely dangerous group of NPS, was administered at different doses to zebrafish larvae (1, 10, 50, 100 µM) in comparison to mice (0.1, 1, 6, 15 mg/kg), as a well-established animal model. A behavioural assay was performed at the time of the peak effect of fentanyl, showing that the results in larvae are consistent with those observed in mice. On the other hand, several morphological abnormalities (namely yolk sac edema, abnormal pericardial edema, jaw defect and spinal curvature) were found in larvae mostly at high fentanyl doses (50, 100 µM). Larva extract and mice urine were analyzed by using liquid chromatography coupled to high resolution mass spectrometry to identify the metabolic pathways of fentanyl. The main metabolites detected were norfentanyl and hydroxyfentanyl in both the tested models. In conclusion, the present study provides evidence that fentanyl effects on zebrafish larvae and metabolism are similar to rodents and consequently support the hypothesis of using zebrafish larvae as a suitable rapid screening tool to investigate new drugs, and particularly NPS. </jats:p

The Cristal Zinc prospect (Amazonas region, northern Peru). Part I: New insights on the sulfide mineralization in the Bongará province

The Cristal Zn prospect consists of a mixed sulfide and nonsulfide mineralization located in the Bongará province (Amazonas region, northern Peru). The mineralization is hosted by carbonate rocks of the Pucará Group, deposited in a Mesozoic extensional basin on the western margin of the Brazilian-Guyana shield. Zinc sulfides at Cristal occur in the roots of the nonsulfide concentrations, and are locally present also nearer to surface. The sulfide mineralization postdates two hydrothermal dolomitization phases (Dol1 and Dol2) and the sulfides occur mainly in veins, cavity fillings or as disseminated mineralization, within sparry to saddle dolomite. They mostly consist of dark-brown sphalerite, intergrown with smaller amounts of pyrite. Sphalerite shows a distinct Fe-zonation, with average ca. 7 wt% Fe (max. ca. 12 wt% Fe), and is Ge-rich (mean concentration of 142 ppm). Galena is rare. The Cristal sphalerite has sulfur isotopic compositions of δ34S = 14 to 15 ‰ VCDT. Oxygen isotopic compositions of dolomites are: δ18O = 24.4 to 24.7 ‰ VSMOW for Dol1 and 18.4 to 22 ‰ for Dol2. δ34S and δ18O values of Cristal sulfides and dolomites are similar to those observed in two Mississippi Valley-type (MVT) deposits located ca. 20–30 km south of the Cristal prospect, namely the Florida Canyon and Florcita deposits. This could be consistent with one or more events within a same MVT mineralizing system, acting at the district scale. The Pb isotope compositions of sphalerite from two different areas of the prospect (named Cristal s.s. and Charlita North) define two distinct data-point clusters (centered around averages of 206Pb/204Pb = 18.850 ± 0.002, 207Pb/204Pb = 15.685 ± 0.002, 208Pb/204Pb = 38.752 ± 0.004, and 206Pb/204Pb = 19.042 ± 0.002, 207Pb/204Pb = 15.712 ± 0.002, 208Pb/204Pb = 39.080 ± 0.004, respectively). This difference requires distinct metal-bearing hydrothermal pulses in the mineralized area and/or distinct Pb sources. The Pb isotopic compositions of the Cristal s.s. and Charlita North sulfides are intermediate between the compositions of galena from the San Vicente and Shalipayco MVT deposits, and record a contribution from an old crustal component. The Paleozoic basement, which has Pb isotopic ratios roughly matching those of dolomites and sulfides from Cristal and Charlita North areas, represents the most reliable candidate to be an end-member source of the metals of the Cristal sulfide mineralization. The second end-member could be an igneous source, isotopically identical to the Late Paleozoic to Early Mesozoic intrusives of the Peruvian Eastern Cordillera, or the Triassic volcanic rocks occurring within the Mitu Group

Are generic and brand-name statins clinically equivalent? Evidence from a real data-base

Background: Use of generic drugs can help contain drug spending. However, there is concern among patients and physicians that generic drugs may be clinically inferior to brand-name ones. This study aimed to compare patients treated with generic and brand-name statins in terms of therapeutic interruption and cardiovascular (CV) outcomes. Methods: 13,799 beneficiaries of the health care system of Lombardy, Italy, aged 40 years or older who were newly treated with generic or brand-name simvastatin during 2008, were followed until 2011 for the occurrence of two outcomes: 1) therapeutic discontinuation and 2) hospitalization for CV events. Hazard ratios (HR) associated with use of generic or brand-name at starting therapy (intention-to-treat analysis) and during follow-up (as-treated analysis) were estimated by fitting proportional hazard Cox models. A Monte-Carlo sensitivity analysis was performed to account for unmeasured confounders. Results: Patients who started on generic did not experience a different risk of discontinuation (HR: 0.98; 95% CI 0.94 to 1.02) nor of CV outcomes (HR: 0.98; 95% CI 0.79 to 1.22) from those starting on brand-name. Patients who spent > 75% of time of follow-up with statin available on generics did not experience a different risk of discontinuation (HR: 0.94; 95% CI 0.87 to 1.01), nor of CV outcomes (HR: 1.06; 95% CI 0.83 to 1.34), compared with those who mainly or only used brand-name statin. Conclusions: Our findings do not support the notion that in the real world clinical practice brand-name statins are superior to generics for keeping therapy and preventing CV outcomes