Tintas anti-incrustantes derivadas de plantas terrestres: uma solução segura para o meio ambiente no controle da bioincrustação

Invertebrates (e.g, barnacles, mussels) are usually the main responsibles for the industrial and naval high economic costs of biofouling, aggravated by colonization of invasive species such (e.g., golden mussel, Limnoperna fortunei). Many strategies have been used as attempts to control biofouling. However, these are not efficient or cause high mortality of aquatic organisms, including the antifouling coatings. Currently, with the aim of preserving human and environmental health, new studies have focused on the discovery of new natural agents to replace the toxic synthetic molecules in paints. The study of bioactive natural products from terrestrial plants has been a promising option in the clinical field and they can have the same potential in the aquatic field. In this way, the main question of this study is: How to select the most promising extracts and compounds? This review evaluated the documents published on this topic, with the aim of highlighting the information necessary to focus antifouling investigations derived from terrestrial plants. A total of 29 papers were examined in this review from 1990 to 2020. Natural products derived from terrestrial plants have great potential as sustainable antifouling, inhibiting colonization of micro and macrofouling. Alkaloid and flavonoid compounds from the Zingiberaceae, Myrtaceae and Fagaceae families have already shown promising results against mussels.Los invertebrados (por ejemplo, cirripedios y mejillones) son los principales responsables de las pérdidas económicas industriales y navales de la bioincrustación, agravada por la colonización de especies invasoras (por ejemplo, el mejillón dorado, Limnoperna fortunei). Se han utilizado diversas estrategias para controlar la bioincrustación. Sin embargo, no son eficientes o causan una alta mortalidad de organismos acuáticos, incluso las tintas antiincrustantes. Actualmente, con la necesidad de preservar la salud humana y ambiental, se han enfocado en la investigación de nuevos agentes naturales para reemplazar las moléculas sintéticas tóxicas de estas pinturas. El estudio de productos naturales bioactivos a partir de plantas terrestres ha sido una opción prometedora en el campo clínico y puede tener el mismo potencial en el acuático. Así, la principal pregunta de este estudio es: ¿Cómo seleccionar los extractos y compuestos más prometedores? Este trabajo analizó artículos publicados sobre el tema con el objetivo de resaltar la información necesaria para centrar las investigaciones en antiincrustantes derivados de plantas terrestres. Se examinaron 29 artículos entre 1990 y 2020. Los productos naturales derivados de plantas terrestres tienen un gran potencial como antiincrustantes sostenibles, inhibiendo la colonización de micro y macrofouling. Los compuestos alcaloides y flavonoides de las familias  , Myrtaceae y Fagaceae ya han mostrado resultados prometedores contra mejillones.Invertebrados (por exemplo, cirripédios, mexilhões) são os principais responsáveis ​​pelos prejuízos econômicos industriais e navais da bioincrustação, agravados pela colonização de espécies invasoras (por exemplo, mexilhão dourado, Limnoperna fortunei). Muitas estratégias têm sido usadas para controlar a bioincrustação. No entanto, não são eficientes ou causam alta mortalidade de organismos aquáticos, incluindo as tintas anti-incrustantes. Atualmente, com a necessidade de preservar a saúde humana e ambiental têm se concentrado na investigação de novos agentes naturais para substituir as moléculas sintéticas tóxicas dessas tintas. O estudo de produtos naturais bioativos de plantas terrestres tem sido uma opção promissora no campo clínico e elas podem ter o mesmo potencial no campo aquático. Desse modo, a principal pergunta deste estudo é: Como selecionar os extratos e compostos mais promissores? Este trabalho analisou artigos publicados sobre este tópico, com o objetivo de destacar as informações necessárias para focalizar a pesquisa em anti-incrustantes derivados de plantas terrestres. Foram examinados 29 artigos de 1990 a 2020. Os produtos naturais derivados de plantas terrestres têm um grande potencial como anti-incrustantes sustentáveis, inibindo a colonização de micro e macro-organismos. Compostos alcalóides e flavonóides das famílias Zingiberaceae, Myrtaceae e Fagaceae já apresentaram resultados promissores contra mexilhões

Estructura de la comunidad bentónica en un tramo inferior del Río Uruguay y potenciales indicadores para la evaluación de efluentes de plantas de celulosa

Tribunal: Dr. Omar Defeo, Dr. Alejandro Brazeiro, Dra. Mariana Meerhoff.Orientador: Dr. Néstor Mazze

Especies acuáticas invasoras en Latinoamérica: ¿nuevos indicadores de viejos problemas?

Recent  problems  that  in  various  Latinamerican countries  have  caused  invader  aquatic  plants (Hydrilla  verticillata  and  Lemna  obscura)  and mollusks  with  invader  or  potentially  invader behaviour   (Limnoperna   fortunei,   Corbicula fluminea) are accounted. The general characteristics of the different species are pointed out, together with the invaded ecosystems, the potential causes and consequences of the invasion, and the expenses caused to the users of the invaded systems. The need of future approaches, studies and normatives in the countries of the region are indicated.Se da cuenta de recientes problemas que en varios países de Latinoamérica han causado plantas acuáticas invasoras (Hydrilla verticillata y Lemna obscura) y moluscos con com-portamiento invasor o potencialmente invasor (Limnoperna fortunei, Corbicula fluminea). Se señala las características generales  de  las  diferentes  especies,  los  ecosistemas invadidos, las causas y consecuencias potenciales de su invasión, así como los gastos ocasionados en los usuarios de los sistemas invadidos. Se indica la necesidad de futuros enfoques, estudios y normativa en los países de la región

Benthic assemblages of a temperate estuarine system in South America: Transition from a freshwater to an estuarine zone

The objectives of the present study were to describe the species composition, diversity and distribution of the zoobenthic assemblages, to estimate the abundance and biomass of the dominant species, and to identify the main environmental factors determining the distribution patterns of the invertebrates from a freshwater to an estuarine zone in a temperate estuary of South America. The Río de la Plata estuary is a microtidal system characterized by a high concentration of suspended solids. Fifty-three taxa of meso- and macro-invertebrates were identified in the samples collected during November and December 2001. Molluscs, annelids, crustaceans and nematodes were found at 90% of the sampling sites. Molluscs comprised up to about 90% of the total zoobenthos biomass: the remaining percentage corresponded mainly to annelids and less to nematodes and crustaceans. An ecocline along the salinity gradient could be observed for the benthic assemblages from the freshwater to the estuarine zone in Rio de la Plata. A Canonical Correspondence Analysis shows that results from sampling sites in the outer zone were strongly related to salinity, depth and pH and less to oxygen and percentage of clay. The results from stations in the inner zone, and part of the middle zone, were mainly related to the occurrence of sand and contents of NH4+–N, NO3−–N, and PO43−–P.Fil: Cortelezzi, Agustina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Instituto de Limnología ; ArgentinaFil: Rodrigues Capitulo, Alberto. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Instituto de Limnología ; ArgentinaFil: Boccardi, Lucía. Universidad de la República. Facultad de Ciencias; UruguayFil: Arocena, Rafael. Universidad de la República. Facultad de Ciencias; Urugua

Golden mussel Limnoperna fortunei (Bivalvia: Mytilidae) distribution in the main hydrographical basins of Uruguay: update and predictions

Limnoperna fortunei, an Asiatic rivers bivalve has become a worldwide problematic invasive species causing several water quality and macrofouling problems. In the Neotropical region it was first recorded in 1991 in the Río de la Plata coast, Buenos Aires province. Since this, it showed a quick upstream invasion into the principals aquatic systems of the Plata Basin. Nevertheless, there is not a study about its invasion and distribution process in aquatic systems of Uruguay. We describe the new records of Limnoperna fortunei in Uruguayan coast of Río de la Plata, Santa Lucía, Negro and Uruguay Rivers. With these results we aim to estimate its distributional limits for Uruguay main hydrographical basins. We also deal with the role of salinity as the main abiotic factor in limiting the east distribution of this mussel in Uruguayan coast of Río de la Plata and as a potential determinant of the "new" colonization on the Atlantic and the Merín Lagoon Basins. Its presence in the ecosystems not only can cause changes at the ecosystem level but also endanger the associated community, favoring the displacement and the disappearance of endemic species.<br>Limnoperna fortunei, é um bivalve invasor de origem asiática que ocasiona problemas na qualidade d'água e poluição em diversas parte do mundo. Na região Neotropical foi registrado pela primeira vez na costa do Rio de la Plata, província de Buenos Aires. Desde então mostrou uma rápida invasão águas acima nos principais sistemas aquáticos da Bacia del Plata. Porém, ainda não existem estudos acerca do processo de invasão e distribuição nos ecossistemas aquáticos do Uruguai. O presente trabalho descreve os novos registros de Limnoperna fortunei na costa uruguaia do Rio de la Plata e dos Rios Santa Lucia e Uruguai. Os presentes resultados permitem avaliar seus limites de distribuição nas principais bacias hidrográficas do Uruguai. Discute-se o papel da salinidade como o principal fator abiótico limitante da distribuição deste mexilhão dourado na costa Uruguaia do Rio de la Plata e como potencial determinante na nova colonização nas bacias hidrográficas das Lagoas Merin e Atlântica. Sua presença nos ecossistemas aquáticos pode ocasionar não apenas mudanças a nível do ecossistema, mas também pôr em perigo as comunidades associadas favorecendo o desaparecimento das espécies endêmicas

Línea de base para evaluar el impacto de una planta de celulosa en el Río Uruguay

In the framework of the environmental impact assessment process undertaken for the commissioning of the Kraft Botnia (currently UPM) paper mill, baseline studies were conducted between 2005 and 2007. The sampling design included three transections perpendicular to the coast line at three sites: Nuevo Berlín, Fray Bentos and Las Cañas. The work included testing of physicochemical parameters of water (nutrients, organic matter, metals, adsorbable organic compounds (AOX), dioxins and furanes), sediment organic matter and granulometry, biological studies of the planktonic, zoobenthonic and fish communities, and bioaccumulation of dioxins in fish. As an average, phosphorus in the water column presented values above those recommended by the national norms, while organic pollutants (AOX, chlorophenols, resinic acids, phytosterols, dioxins and furanes) remained below the guidance values recommended at an international level. Planktonic communities varied significantly across samplings; fish communities varied between sites and samplings, while the benthos results did not show significant space or time variations. The hag Iheringichthys labrosus has been proposed as the most suitable indicator species to be monitored, owing to its ubiquity and abundance. This paper offers an overview of the baseline assessments,highlighting the multiplicity and periodicity of the parameters collected in the course of two years.Como parte del proceso de evaluación del impacto ambiental ante la puesta en funcionamiento de la planta de pulpa de celulosa Kraft Botnia (actual UPM), se realizaron estudios de línea de base entre los años 2005 y 2007. El diseño de muestreo incluyó tres transectas perpendiculares a la línea de costa, en tres sitios: Nuevo Berlín, Fray Bentos y Las Cañas. Se realizaron estudios de parámetros físico-químicos del agua (nutrientes, sustancias orgánicas, metales, compuestos orgánicos adsorbibles (AOX), dioxinas y furanos), materia orgánica y granulometría del sedimento, estudios biológicos de las comunidades planctónicas, zoobentónicas e ícticas y bioacumulación de dioxinas en peces. El fósforo en la columna de agua presentó en promedio valores por encima de lo recomendado por la normativa nacional, mientras los contaminantes orgánicos (AOX, clorofenoles, ácidos resínicos, fitosteroles, dioxinas y furanos) se mantuvieron por debajo de los valores guía recomendados a nivel internacional. Las comunidades planctónicas variaron significativamente entre muestreos, la de peces entre sitios y muestreos, mientras que la de bentos no presentó variaciones significativas espaciales ni temporales. El bagre trompudo (Iheringichthys labrosus) es propuesto como especie a sermonitoreada debido a su ubicuidad y abundancia. Este trabajo ofrece una visión general de los estudios de línea de base, destacando la multiplicidad y la periodicidad de los parámetros en dos años de estudio

Polypharmacy in older people: lessons from 10 years of experience with the REPOSI register

reserved361siAs a consequence of population aging, we have witnessed in internal medicine hospital wards a progressive shift from a population of in-patients relatively young and mainly affected by a single ailment to one of ever older and more and more complex patients with multiple chronic diseases, followed as out-patients by many different specialists with poor integration and inevitably treated with multiple medications. Polypharmacy (defined as the chronic intake of five or more drugs) is associated with increased risks of drug-drug interactions and related adverse effects, prescription and intake errors, poor compliance, re-hospitalization and mortality. With this background, the Italian Society of Internal Medicine chose to start in 2008 a prospective register called REPOSI (REgistro POliterapie SIMI, Società Italiana di Medicina Interna) in internal medicine and geriatric hospital wards. The country wide register is an ongoing observatory on multimorbidity and polypharmacy in the oldest old, with the goal to improve prescription appropriateness and, thus to avoid potentially inappropriate medications. The main findings of the register, that has accrued so far, 7005 older patients throughout a 10 year period, are summarized herewith, with special emphasis on the main patterns of poor prescription appropriateness and related risks of adverse events.mixedMannucci PM, Nobili A, Pasina L; Tettamanti M, Franchi C, Corrao S, Marengoni A, Salerno F, Cesari M, Perticone F, Licata G, Violi F, Corazza GR, Franchi C, Cortesi L, Tettamanti M, Cortesi L, Ardoino I, Prisco D, Silvestri E, Cenci C, Emmi G, Biolo G, Zanetti M, Guadagni M, Zaccari M, Vanoli M, Grignani G, Pulixi EA, Bernardi M, Bassi SL, Santi L, Zaccherini G, Mannarino E, Lupattelli G, Bianconi V, Paciullo F, Nuti R, Valenti R, Ruvio M, Cappelli S, Palazzuoli A, Olivieri O, Girelli D, Matteazzi T, Barbagallo M, Dominguez L, Cocita F, Beneduce V, Plances L, Zoli M, Lazzari I, Brunori M, Pasini FL, Capecchi PL, Palasciano G, Modeo ME, Di Gennaro C, Cappellini MD, Maira D, Di Stefano V, Fabio G, Seghezzi S, Mancarella M, Cesari M, Rossi PD, Damanti S, Clerici M, Conti F, Corazza GR, Miceli E, Lenti MV, Pisati M, Dominioni CC, Murialdo G, Marra A, Cattaneo F, Secchi MB, Ghelfi D, Anastasio L, Sofia L, Carbone M, Cipollone F, Guagnano MT, Angelucci E, Valeriani E, Mancuso G, Calipari D, Bartone M, Delitala G, Berria M, Muscaritoli M, Molfino A, Petrillo E, Zuccalà G, D'Aurizio G, Romanelli G, Marengoni A, Zucchelli A, Picardi A, Gentilucci UV, Gallo P, Dell'Unto C, Annoni G, Corsi M, Bellelli G, Zazzetta S, Mazzola P, Szabo H, Bonfanti A, Arturi F, Succurro E, Rubino M, Serra MG, Bleve MA, Gasbarrone L, Sajeva MR, Brucato A, Ghidoni S, Fabris F, Bertozzi I, Bogoni G, Rabuini MV, Cosi E, Manfredini R, Fabbian F, Boari B, De Giorgi A, Tiseo R, Paolisso G, Rizzo MR, Borghi C, Strocchi E, De Sando V, Pareo I, Sabbà C, Vella FS, Suppressa P, Agosti P, Schilardi A, Loparco F, Fenoglio L, Bracco C, Giraudo AV, Fargion S, Periti G, Porzio M, Tiraboschi S, Peyvandi F, Rossio R, Ferrari B, Colombo G, Monzani V, Savojardo V, Folli C, Ceriani G, Salerno F, Pallini G, Dallegri F, Ottonello L, Liberale L, Caserza L, Salam K, Liberato NL, Tognin T, Bianchi GB, Giaquinto S, Purrello F, Di Pino A, Piro S, Rozzini R, Falanga L, Spazzini E, Ferrandina C, Montrucchio G, Petitti P, Salmi R, Gaudenzi P, Violi F, Perri L, Landolfi R, Montalto M, Mirijello A, Guasti L, Castiglioni L, Maresca A, Squizzato A, Molaro M, Grossi A, Bertolotti M, Mussi C, Libbra MV, Dondi G, Pellegrini E, Carulli L, Perticone F, Colangelo L, Falbo T, Stanghellini V, De Giorgio R, Ruggeri E, Del Vecchio S, Salvi A, Leonardi R, Damiani G, Gabrielli A, Capeci W, Mattioli M, Martino GP, Biondi L, Pettinari P, Ghio R, Col AD, Minisola S, Colangelo L, Afeltra A, Marigliano B, Pipita ME, Castellino P, Blanco J, Zanoli L, Pignataro S, Saracco V, Fogliati M, Bussolino C, Mete F, Gino M, Cittadini A, Vigorito C, Arcopinto M, Salzano A, Bobbio E, Marra AM, Sirico D, Moreo G, Gasparini F, Prolo S, Pina G, Ballestrero A, Ferrando F, Berra S, Dassi S, Nava MC, Graziella B, Baldassarre S, Fragapani S, Gruden G, Galanti G, Mascherini G, Petri C, Stefani L, Girino M, Piccinelli V, Nasso F, Gioffrè V, Pasquale M, Scattolin G, Martinelli S, Turrin M, Sechi L, Catena C, Colussi G, Passariello N, Rinaldi L, Berti F, Famularo G, Patrizia T, Castello R, Pasino M, Ceda GP, Maggio MG, Morganti S, Artoni A, Del Giacco S, Firinu D, Losa F, Paoletti G, Montalto G, Licata A, Malerba V, Antonino L, Basile G, Antonino C, Malatino L, Stancanelli B, Terranova V, Di Marca S, Mecocci P, Ruggiero C, Boccardi V, Meschi T, Lauretani F, Ticinesi A, Minuz P, Fondrieschi L, Pirisi M, Fra GP, Sola D, Porta M, Riva P, Quadri R, Scanzi G, Mengoli C, Provini S, Ricevuti L, Simeone E, Scurti R, Tolloso F, Tarquini R, Valoriani A, Dolenti S, Vannini G, Tedeschi A, Trotta L, Volpi R, Bocchi P, Vignali A, Harari S, Lonati C, Cattaneo M, Nieves RD, Alberto MM, Pedro AR, Vanessa LP, Lara T, Xavier CV, Francesc F, Jesus DM, Esperanza BT, Esther DCB, Maria SP, Romero M, Blanca PL, Cristina LG, Victoria VGM, Saez L, Bosco J, Susana SB, Marta AG, Concepcion GB, Antonio FM, Hernandez MG, Borrego MP, Raquel PC, Florencia PR, Beatriz GO, Sara CG, Alfonso GC, Marta PM, Garcia SC, Alberto RC, Antonio AA, Montserrat GG, Ángel BRM, Manuel MJ, Ignacio NV, Lucía AS, Alfonso L, David RB, Iria IV, Monica RP.Mannucci, Pm; Nobili, A; Pasina, L; Tettamanti, M; Franchi, C; Corrao, S; Marengoni, A; Salerno, F; Cesari, M; Perticone, F; Licata, G; Violi, F; Corazza, Gr; Franchi, C; Cortesi, L; Tettamanti, M; Cortesi, L; Ardoino, I; Prisco, D; Silvestri, E; Cenci, C; Emmi, G; Biolo, G; Zanetti, M; Guadagni, M; Zaccari, M; Vanoli, M; Grignani, G; Pulixi, Ea; Bernardi, M; Bassi, Sl; Santi, L; Zaccherini, G; Mannarino, E; Lupattelli, G; Bianconi, V; Paciullo, F; Nuti, R; Valenti, R; Ruvio, M; Cappelli, S; Palazzuoli, A; Olivieri, O; Girelli, D; Matteazzi, T; Barbagallo, M; Dominguez, L; Cocita, F; Beneduce, V; Plances, L; Zoli, M; Lazzari, I; Brunori, M; Pasini, Fl; Capecchi, Pl; Palasciano, G; Modeo, Me; Di Gennaro, C; Cappellini, Md; Maira, D; Di Stefano, V; Fabio, G; Seghezzi, S; Mancarella, M; Cesari, M; Rossi, Pd; Damanti, S; Clerici, M; Conti, F; Corazza, Gr; Miceli, E; Lenti, Mv; Pisati, M; Dominioni, Cc; Murialdo, G; Marra, A; Cattaneo, F; Secchi, Mb; Ghelfi, D; Anastasio, L; Sofia, L; Carbone, M; Cipollone, F; Guagnano, Mt; Angelucci, E; Valeriani, E; Mancuso, G; Calipari, D; Bartone, M; Delitala, G; Berria, M; Muscaritoli, M; Molfino, A; Petrillo, E; Zuccalà, G; D'Aurizio, G; Romanelli, G; Marengoni, A; Zucchelli, A; Picardi, A; Gentilucci, Uv; Gallo, P; Dell'Unto, C; Annoni, G; Corsi, M; Bellelli, G; Zazzetta, S; Mazzola, P; Szabo, H; Bonfanti, A; Arturi, F; Succurro, E; Rubino, M; Serra, Mg; Bleve, Ma; Gasbarrone, L; Sajeva, Mr; Brucato, A; Ghidoni, S; Fabris, F; Bertozzi, I; Bogoni, G; Rabuini, Mv; Cosi, E; Manfredini, R; Fabbian, F; Boari, B; De Giorgi, A; Tiseo, R; Paolisso, G; Rizzo, Mr; Borghi, C; Strocchi, E; De Sando, V; Pareo, I; Sabbà, C; Vella, Fs; Suppressa, P; Agosti, P; Schilardi, A; Loparco, F; Fenoglio, L; Bracco, C; Giraudo, Av; Fargion, S; Periti, G; Porzio, M; Tiraboschi, S; Peyvandi, F; Rossio, R; Ferrari, B; Colombo, G; Monzani, V; Savojardo, V; Folli, C; Ceriani, G; Salerno, F; Pallini, G; Dallegri, F; Ottonello, L; Liberale, L; Caserza, L; Salam, K; Liberato, Nl; Tognin, T; Bianchi, Gb; Giaquinto, S; Purrello, F; Di Pino, A; Piro, S; Rozzini, R; Falanga, L; Spazzini, E; Ferrandina, C; Montrucchio, G; Petitti, P; Salmi, R; Gaudenzi, P; Violi, F; Perri, L; Landolfi, R; Montalto, M; Mirijello, A; Guasti, L; Castiglioni, L; Maresca, A; Squizzato, A; Molaro, M; Grossi, A; Bertolotti, M; Mussi, C; Libbra, Mv; Dondi, G; Pellegrini, E; Carulli, L; Perticone, F; Colangelo, L; Falbo, T; Stanghellini, V; De Giorgio, R; Ruggeri, E; Del Vecchio, S; Salvi, A; Leonardi, R; Damiani, G; Gabrielli, A; Capeci, W; Mattioli, M; Martino, Gp; Biondi, L; Pettinari, P; Ghio, R; Col, Ad; Minisola, S; Colangelo, L; Afeltra, A; Marigliano, B; Pipita, Me; Castellino, P; Blanco, J; Zanoli, L; Pignataro, S; Saracco, V; Fogliati, M; Bussolino, C; Mete, F; Gino, M; Cittadini, A; Vigorito, C; Arcopinto, M; Salzano, A; Bobbio, E; Marra, Am; Sirico, D; Moreo, G; Gasparini, F; Prolo, S; Pina, G; Ballestrero, A; Ferrando, F; Berra, S; Dassi, S; Nava, Mc; Graziella, B; Baldassarre, S; Fragapani, S; Gruden, G; Galanti, G; Mascherini, G; Petri, C; Stefani, L; Girino, M; Piccinelli, V; Nasso, F; Gioffrè, V; Pasquale, M; Scattolin, G; Martinelli, S; Turrin, M; Sechi, L; Catena, C; Colussi, G; Passariello, N; Rinaldi, L; Berti, F; Famularo, G; Patrizia, T; Castello, R; Pasino, M; Ceda, Gp; Maggio, Mg; Morganti, S; Artoni, A; Del Giacco, S; Firinu, D; Losa, F; Paoletti, G; Montalto, G; Licata, A; Malerba, V; Antonino, L; Basile, G; Antonino, C; Malatino, L; Stancanelli, B; Terranova, V; Di Marca, S; Mecocci, P; Ruggiero, C; Boccardi, V; Meschi, T; Lauretani, F; Ticinesi, A; Minuz, P; Fondrieschi, L; Pirisi, M; Fra, Gp; Sola, D; Porta, M; Riva, P; Quadri, R; Scanzi, G; Mengoli, C; Provini, S; Ricevuti, L; Simeone, E; Scurti, R; Tolloso, F; Tarquini, R; Valoriani, A; Dolenti, S; Vannini, G; Tedeschi, A; Trotta, L; Volpi, R; Bocchi, P; Vignali, A; Harari, S; Lonati, C; Cattaneo, M; Nieves, Rd; Alberto, Mm; Pedro, Ar; Vanessa, Lp; Lara, T; Xavier, Cv; Francesc, F; Jesus, Dm; Esperanza, Bt; Esther, Dcb; Maria, Sp; Romero, M; Blanca, Pl; Cristina, Lg; Victoria, Vgm; Saez, L; Bosco, J; Susana, Sb; Marta, Ag; Concepcion, Gb; Antonio, Fm; Hernandez, Mg; Borrego, Mp; Raquel, Pc; Florencia, Pr; Beatriz, Go; Sara, Cg; Alfonso, Gc; Marta, Pm; Garcia, Sc; Alberto, Rc; Antonio, Aa; Montserrat, Gg; Ángel, Brm; Manuel, Mj; Ignacio, Nv; Lucía, As; Alfonso, L; David, Rb; Iria, Iv; Monica, Rp

Polypharmacy in older people: lessons from 10 years of experience with the REPOSI register.

As a consequence of population aging, we have witnessed in internal medicine hospital wards a progressive shift from a population of in-patients relatively young and mainly affected by a single ailment to one of ever older and more and more complex patients with multiple chronic diseases, followed as out-patients by many different specialists with poor integration and inevitably treated with multiple medications. Polypharmacy (defined as the chronic intake of five or more drugs) is associated with increased risks of drug-drug interactions and related adverse effects, prescription and intake errors, poor compliance, re-hospitalization and mortality. With this background, the Italian Society of Internal Medicine chose to start in 2008 a prospective register called REPOSI (REgistro POliterapie SIMI, Società Italiana di Medicina Interna) in internal medicine and geriatric hospital wards. The country wide register is an ongoing observatory on multimorbidity and polypharmacy in the oldest old, with the goal to improve prescription appropriateness and, thus to avoid potentially inappropriate medications. The main findings of the register, that has accrued so far, 7005 older patients throughout a 10 year period, are summarized herewith, with special emphasis on the main patterns of poor prescription appropriateness and related risks of adverse events

Polypharmacy in older people: lessons from 10 years of experience with the REPOSI register

As a consequence of population aging, we have witnessed in internal medicine hospital wards a progressive shift from a population of in-patients relatively young and mainly affected by a single ailment to one of ever older and more and more complex patients with multiple chronic diseases, followed as out-patients by many different specialists with poor integration and&nbsp;inevitably treated with multiple medications. Polypharmacy (defined as the chronic intake of five or more drugs) is associated with increased risks of drug-drug interactions and related adverse effects, prescription and intake errors, poor compliance, re-hospitalization and mortality. With this background, the Italian Society of Internal Medicine chose to start in 2008 a prospective register called REPOSI (REgistro POliterapie SIMI, Società Italiana di Medicina Interna) in internal medicine and geriatric hospital wards. The country wide register is an ongoing observatory on multimorbidity and polypharmacy in the oldest old, with the goal to improve prescription appropriateness and, thus to avoid potentially inappropriate medications. The main findings of the register, that has accrued so far, 7005 older patients throughout a 10&nbsp;year period, are summarized herewith, with special emphasis on the main patterns of poor prescription appropriateness and related risks of adverse events