Resposta fisiológica e produção do vinhedo de 'Syrah' em função dos sistemas de condução

A arquitetura da planta e sua interação com práticas agronômicas e variáveis ambientais determinam a estrutura do dossel vegetal, que está envolvida na assimilação de carbono, fertilidade das gemas e qualidade da fruta. Neste contexto, avaliou-se o comportamento de um vinhedo de 'Syrah' conduzido nos sistemas espaldeira (VSP) e Dupla Cortina de Geneva modificado (GDC). As avaliações da superfície foliar primária, relações hídricas e assimilação líquida de carbono foram realizadas no final do período de maturação da uva. Foi feita estimativa da produção por planta e por hectare e avaliados o peso e diâmetro das bagas e teores de sólidos solúveis, pH e acidez titulável durante o amadurecimento das bagas. As plantas conduzidas em espaldeira apresentaram melhor hidratação, sendo observadas diferenças no potencial hídrico da folha (ψpd) e do caule (ψstem). A assimilação líquida de CO2 não foi afetada pelos sistemas adotados, e a redução no ψpd e ψstem observada no sistema GDC não alterou a taxa fotossintética. A exposição da fruta foi maior no sistema em espaldeira, o que contribuiu para aumento na temperatura das bagas. Na colheita, as bagas do sistema GDC atingiram valores próximos a 23 ºBrix, enquanto no sistema em espaldeira, os valores não passaram de 21 ºBrix.Plant architecture and its interaction with agricultural practices and environmental constraints is determinant for grapevine canopy structure, which is related to carbon assimilation, bud fertility and fruit quality. In this context, this study evaluated the performance of field-grown 'Syrah' grapevines conducted by two management systems: Vertical Shoot Position (VSP) or a modified Geneva Double Curtain (GDC), in Pirapora, state of Minas Gerais, Brazil, during the winters of 2007 and 2008. The evaluations of leaf area, water relations and net CO2 assimilation were made at the end of the ripening period. Yield per vine and per hectare were estimated and mean berry weight and diameter, total soluble solids, pH and titratable acidity were evaluated during berry ripening. The grapevines trained in VSP had higher water status as compared to GDC, shown by differences in pre-dawn leaf water potential (ψpd) and stem water potential (ψstem). However, the CO2 assimilation was similar in both training systems. Fruit exposure was higher in VSP than in GDC, which contributed to increasing berry temperature. At harvest, the berries in GDC reached values near to 23 ºBrix whereas berries in VSP showed values near 21 ºBrix

Hematopietic Stem Cell Transplantation in Thalassemia and Related Disorders

The basis of allogeneic hemopoietic stem cell (HSC) transplantation in thalassemia consists in substituting the ineffective thalassemic erythropoiesis with and allogeneic effective one. This cellular replacement therapy is an efficient way to obtain a long lasting, probably permanent, clinical effective correction of the anaemia avoiding transfusion requirement and subsequent complications like iron overload. The first HSC transplant for thalassemia was performed in Seattle on Dec 2, 1981. In the early eighties transplantation procedure was limited to very few centres worldwide. Between 17 December 1981 and 31 January 2003, over 1000 consecutive patients, aged from 1 to 35 years, underwent transplantation in Pesaro. After the pioneering work by the Seattle and Pesaro groups, this therapeutic approach is now widely applied worldwide. Medical therapy of thalassemia is one of the most spectacular successes of the medical practice in the last decades. In recent years advances in knowledge of iron overload patho-physiopathology, improvement and diffusion of diagnostic capability together with the development of new effective and safe oral chelators promise to further increase success of medical therapy. Nevertheless situation is dramatically different in non-industrialized countries were the very large majority of patients live today. Transplantation technologies have improved substantially during the last years and transplantation outcome is likely to be much better today than in the ‘80s. Recent data indicated a probability of overall survival and thalassemia free survival of 97% and 89% for patients with no advanced disease and of 87% and 80% for patients with advanced disease. Thus the central role of HSC in thalassemia has now been fully established. HSC remains the only definitive curative therapy for thalassemia and other hemoblobinopathies. The development of oral chelators has not changed this position. However this has not settled the controversy on how this curative but potentially lethal treatment stands in front of medical therapy for adults and advanced disease patients. In sickle cell disease HSC transplantation currently is reserved almost exclusively for patients with clinical features that indicate a poor outcome or significant sickle-related morbidity

Smoking Habit Prevention in Schools: Report of a Pediatric Educational Intervention Held in Pisa

Introduction: Smoking is the leading preventable cause of death in the world and the detrimental effects of tobacco on health have been described across the full life span. There is no safe level of tobacco exposure and childhood is the more vulnerable period of life. Current estimates show that 10% of children aged 13-15 years are active smokers and most of them started smoking at ≥11 years of age, due to peer and/or family influence. Moreover, recently, e-cigarette use has spread, particularly among youth. Many school-based smoking prevention interventions have been carried out around the world, the efficacy of which has yet to be established. Materials and methods: In February 2018 we planned an educational program on smoking habit within the Italian Society of Pediatric Respiratory Diseases (SIMRI) (“Dai un calcio al fumo” program). In May 2018 we held 8 interventions at the Fibonacci School (Pisa, Italy), meeting 365 children aged 9 to 13 years and involving a pediatrician and a pediatric resident in a 2-hour lesson focusing on the importance of a healthy lifestyle and smoking habit effects. The children were invited to ask questions and talk about their experiences, with a subsequent 30-minutes collegial discussion. The most frequent questions were collected, as well as students’, physicians’ and teachers’ opinions on each meeting. Results: During our educational interventions the most frequently asked questions were about the discrepancy related to the fact that a dangerous product is legally sold and the potential harmful effects of e-cigarettes. All the children stated that they knew that combustible cigarette smoking was dangerous. Most of them admitted that they feel that smoking habits start from emulating friends and relatives. Almost 70% of the children reported to have at least one smoker relative. Teachers, physicians and students proposed to replicate the meetings the following year. Conclusions: The considerable interest shown by the students, together with the low cost and potential effectiveness of school-based educational measures, suggest that in our country a national educational program should be introduced in schools. Too many children are still exposed to tobacco smoke in the household environment

Bovine Colostrum Supplementation Modulates the Intestinal Microbial Community in Rabbits

Simple Summary Recently, research has focused on the modulation of the gut microbiota because of its central role in several digestive physiological functions and its involvement in the onset of not only gastrointestinal but also systemic diseases. Supplementing rabbit diets with nutraceutical substances could be a strategy to prevent dysbiosis, strengthen the immune system, and reduce mortality during the critical weaning period. Bovine colostrum (BC) is a by-product of the dairy industry and is very rich in compounds with several biological activities. Its use as an intestinal microbiota modulator in rabbits has never been investigated. This study evaluates the effects of diet supplementation with two different percentages of BC (2.5 and 5%) on luminal and mucosa-associated microbiota and its metabolism-associated pathways in the jejunum, caecum, and colon of rabbits. Although our results showed no effect of BC on microbiota biodiversity, there were significant differences between experimental groups in the microbial composition, mainly at the level of sub-dominant components depending on the dose of supplementation. The metabolism-associated pathways have also been affected, and particularly interesting are the results on the amino acids and lactose metabolism. Overall, findings suggest that BC could be used as a supplement in rabbit feed, although its effects on productive and reproductive performances, intestinal disease resistance, and economic aspects need to be further evaluated. BC is a nutraceutical that can modulate intestinal microbiota. This study investigates the effects of BC diet supplementation on luminal and mucosa-associated microbiota in the jejunum, caecum, and colon of rabbits. Twenty-one New Zealand White female rabbits were divided into three experimental groups (n = 7) receiving a commercial feed (CTRL group) and the same diet supplemented with 2.5% and 5% BC (2.5% BC and 5% BC groups, respectively), from 35 (weaning) to 90 days of age (slaughtering). At slaughter, the digestive tract was removed from each animal, then both content and mucosa-associated microbiota of jejunum, caecum, and colon were collected and analysed by Next Generation 16SrRNA Gene Sequencing. Significant differences were found in the microbial composition of the three groups (i.e., beta-diversity: p < 0.01), especially in the caecum and colon of the 2.5% BC group. The relative abundance analysis showed that the families most affected by the BC administration were Clostridia UCG-014, Barnesiellaceae, and Eggerthellaceae. A trend was also found for Lachnospiraceae, Akkermansiaceae, and Bacteroidaceae. A functional prediction has revealed several altered pathways in BC groups, with particular reference to amino acids and lactose metabolism. Firmicutes:Bacteroidetes ratio decreased in caecum luminal samples of the 2.5% BC group. These findings suggest that BC supplementation could positively affect the intestinal microbiota. However, further research is needed to establish the optimal administration dose

Physiological responses and production of 'Syrah' vines as a function of training systems

Plant architecture and its interaction with agricultural practices and environmental constraints is determinant for grapevine canopy structure, which is related to carbon assimilation, bud fertility and fruit quality. In this context, this study evaluated the performance of field-grown 'Syrah' grapevines conducted by two management systems: Vertical Shoot Position (VSP) or a modified Geneva Double Curtain (GDC), in Pirapora, state of Minas Gerais, Brazil, during the winters of 2007 and 2008. The evaluations of leaf area, water relations and net CO2 assimilation were made at the end of the ripening period. Yield per vine and per hectare were estimated and mean berry weight and diameter, total soluble solids, pH and titratable acidity were evaluated during berry ripening. The grapevines trained in VSP had higher water status as compared to GDC, shown by differences in pre-dawn leaf water potential (ψpd) and stem water potential (ψstem). However, the CO2 assimilation was similar in both training systems. Fruit exposure was higher in VSP than in GDC, which contributed to increasing berry temperature. At harvest, the berries in GDC reached values near to 23 ºBrix whereas berries in VSP showed values near 21 ºBrix

Antidiabetic Drug Prescription Pattern in Hospitalized Older Patients with Diabetes

Objective: To describe the prescription pattern of antidiabetic and cardiovascular drugs in a cohort of hospitalized older patients with diabetes. Methods: Patients with diabetes aged 65 years or older hospitalized in internal medicine and/or geriatric wards throughout Italy and enrolled in the REPOSI (REgistro POliterapuie SIMI—Società Italiana di Medicina Interna) registry from 2010 to 2019 and discharged alive were included. Results: Among 1703 patients with diabetes, 1433 (84.2%) were on treatment with at least one antidiabetic drug at hospital admission, mainly prescribed as monotherapy with insulin (28.3%) or metformin (19.2%). The proportion of treated patients decreased at discharge (N = 1309, 76.9%), with a significant reduction over time. Among those prescribed, the proportion of those with insulin alone increased over time (p = 0.0066), while the proportion of those prescribed sulfonylureas decreased (p < 0.0001). Among patients receiving antidiabetic therapy at discharge, 1063 (81.2%) were also prescribed cardiovascular drugs, mainly with an antihypertensive drug alone or in combination (N = 777, 73.1%). Conclusion: The management of older patients with diabetes in a hospital setting is often sub-optimal, as shown by the increasing trend in insulin at discharge, even if an overall improvement has been highlighted by the prevalent decrease in sulfonylureas prescription

The “Diabetes Comorbidome”: A Different Way for Health Professionals to Approach the Comorbidity Burden of Diabetes

(1) Background: The disease burden related to diabetes is increasing greatly, particularly in older subjects. A more comprehensive approach towards the assessment and management of diabetes’ comorbidities is necessary. The aim of this study was to implement our previous data identifying and representing the prevalence of the comorbidities, their association with mortality, and the strength of their relationship in hospitalized elderly patients with diabetes, developing, at the same time, a new graphic representation model of the comorbidome called “Diabetes Comorbidome”. (2) Methods: Data were collected from the RePoSi register. Comorbidities, socio-demographic data, severity and comorbidity indexes (Cumulative Illness rating Scale CIRS-SI and CIRS-CI), and functional status (Barthel Index), were recorded. Mortality rates were assessed in hospital and 3 and 12 months after discharge. (3) Results: Of the 4714 hospitalized elderly patients, 1378 had diabetes. The comorbidities distribution showed that arterial hypertension (57.1%), ischemic heart disease (31.4%), chronic renal failure (28.8%), atrial fibrillation (25.6%), and COPD (22.7%), were the more frequent in subjects with diabetes. The graphic comorbidome showed that the strongest predictors of death at in hospital and at the 3-month follow-up were dementia and cancer. At the 1-year follow-up, cancer was the first comorbidity independently associated with mortality. (4) Conclusions: The “Diabetes Comorbidome” represents the perfect instrument for determining the prevalence of comorbidities and the strength of their relationship with risk of death, as well as the need for an effective treatment for improving clinical outcomes

Clinical features and outcomes of elderly hospitalised patients with chronic obstructive pulmonary disease, heart failure or both

Background and objective: Chronic obstructive pulmonary disease (COPD) and heart failure (HF) mutually increase the risk of being present in the same patient, especially if older. Whether or not this coexistence may be associated with a worse prognosis is debated. Therefore, employing data derived from the REPOSI register, we evaluated the clinical features and outcomes in a population of elderly patients admitted to internal medicine wards and having COPD, HF or COPD + HF. Methods: We measured socio-demographic and anthropometric characteristics, severity and prevalence of comorbidities, clinical and laboratory features during hospitalization, mood disorders, functional independence, drug prescriptions and discharge destination. The primary study outcome was the risk of death. Results: We considered 2,343 elderly hospitalized patients (median age 81 years), of whom 1,154 (49%) had COPD, 813 (35%) HF, and 376 (16%) COPD + HF. Patients with COPD + HF had different characteristics than those with COPD or HF, such as a higher prevalence of previous hospitalizations, comorbidities (especially chronic kidney disease), higher respiratory rate at admission and number of prescribed drugs. Patients with COPD + HF (hazard ratio HR 1.74, 95% confidence intervals CI 1.16-2.61) and patients with dementia (HR 1.75, 95% CI 1.06-2.90) had a higher risk of death at one year. The Kaplan-Meier curves showed a higher mortality risk in the group of patients with COPD + HF for all causes (p = 0.010), respiratory causes (p = 0.006), cardiovascular causes (p = 0.046) and respiratory plus cardiovascular causes (p = 0.009). Conclusion: In this real-life cohort of hospitalized elderly patients, the coexistence of COPD and HF significantly worsened prognosis at one year. This finding may help to better define the care needs of this population

Clinical features and outcomes of elderly hospitalised patients with chronic obstructive pulmonary disease, heart failure or both

Background and objective: Chronic obstructive pulmonary disease (COPD) and heart failure (HF) mutually increase the risk of being present in the same patient, especially if older. Whether or not this coexistence may be associated with a worse prognosis is debated. Therefore, employing data derived from the REPOSI register, we evaluated the clinical features and outcomes in a population of elderly patients admitted to internal medicine wards and having COPD, HF or COPD + HF. Methods: We measured socio-demographic and anthropometric characteristics, severity and prevalence of comorbidities, clinical and laboratory features during hospitalization, mood disorders, functional independence, drug prescriptions and discharge destination. The primary study outcome was the risk of death. Results: We considered 2,343 elderly hospitalized patients (median age 81 years), of whom 1,154 (49%) had COPD, 813 (35%) HF, and 376 (16%) COPD + HF. Patients with COPD + HF had different characteristics than those with COPD or HF, such as a higher prevalence of previous hospitalizations, comorbidities (especially chronic kidney disease), higher respiratory rate at admission and number of prescribed drugs. Patients with COPD + HF (hazard ratio HR 1.74, 95% confidence intervals CI 1.16-2.61) and patients with dementia (HR 1.75, 95% CI 1.06-2.90) had a higher risk of death at one year. The Kaplan-Meier curves showed a higher mortality risk in the group of patients with COPD + HF for all causes (p = 0.010), respiratory causes (p = 0.006), cardiovascular causes (p = 0.046) and respiratory plus cardiovascular causes (p = 0.009). Conclusion: In this real-life cohort of hospitalized elderly patients, the coexistence of COPD and HF significantly worsened prognosis at one year. This finding may help to better define the care needs of this population