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

Mapping of the Major Psoriasis-Susceptibility Locus (PSORS1) in a 70-Kb Interval around the Corneodesmosin Gene (CDSN)

Numerous putative susceptibility loci have been described for psoriasis. Among the loci confirmed in the literature, PSORS1 (the major histocompatibility complex at 6p21.3) has the strongest effect. Recent studies have highlighted a 200-kb candidate region. However, this region has not been well delimited, mainly because of the strong linkage equilibrium among the associated alleles. To finely map PSORS1, we set up a study using 17 polymorphic markers in a 525-kb interval around the human leucocyte antigen C locus (HLA-C). The results uncovered five loci with alleles strongly associated with psoriasis (Sidak-corrected P [P(c)] values from 1.8 × 10(−7) to .003), all structured in a psoriasis-susceptibility haplotype (PSH). Subsequent analysis of extended haplotypes showed that the PSH was not only present on the traditional psoriasis-susceptibility extended haplotypes (HLA-Cw6-B57, HLA-Cw6-B37, and HLA-Cw6-B13) but also on a haplotype of Sardinian origin (HLA-Cw7-B58) found to be associated with psoriasis (P(c)=.0009) because of an ancestral recombination with one of the susceptibility haplotypes carrying the HLA-Cw6 allele. Comparisons of the regions identical by descent among associated and nonassociated haplotypes highlighted a minimum region of 70 kb not recombinant with PSORS1, around the corneodesmosin (CDSN) gene

Modelling Miniature Microbial Fuel Cells with Three-dimensional Anodes

Microbial fuel cells (MFCs) exploit the metabolic activity of electroactive microorganisms for oxidation of organic compounds and extracellular electron transfer to an external electrode. the technology is associate with very slowreaction rates, resulting in low current densities. Anodes with high specific surface should be used to increase the overall electricity generation. Carbon-based 3D materials, with high surface per unit of volume, are largely used anode materials in MFCs, although may show significant lack in efficiency due to mass transfer limitations, concentration gradients, velocity distribution and resistivity of the material. Consequently, the concomitant effect of several parameters should be assessed and quantified to design highly performing MFCs implementing 3D anode materials. In this work, miniature MFCs with 3D anodes are mathematically modelled to quantify the effect of operative parameters on performance. The model combines equations of charge conservation, mass transport phenomena, hydrodynamics, and kinetics of the involved processes under transient conditions, and provides 3D profiles with time of velocity, biofilm thickness, substrate concentration, current density and potential. The solution predicts a laminar flow, as it was expected with the low flow rates used. The concentration profiles show the consumption of substrate in the anode, with low values of local concentrations depending on organic load in the feed stream. The model also provides a versatile tool to optimise the operative conditions of the system, managing the flow arrangements to maximise either substrate removal or electricity generation

As noções construídas por adolescentes sobre feminilidade nas redes sociais

Este trabajo presenta el resultado de una pesquisa que buscó investigar las nociones construidas por adolescentes con edades entre 13 y 18 años sobre la feminidad en las redes sociales de internet. Se utilizó, como método, la pesquisa cualitativa desde textos por ellas publicados. Las discusiones teóricas que orientaron la lectura de los escritos de las adolescentes se dieron bajo cuatro ejes principales: adolescencia, cuerpo, femenino y contemporaneidad, teniendo el psicoanálisis de orientación lacaniana como principal referencial teórico. La hipótesis defendida en este artículo es la de que las adolescentes utilizan los objetos de consumo ligados al cuerpo como una forma de construir una identidad supuestamente femenina en la actualidad

Psychoanalysis, education and virtual social networds: listen adolescents in school

O interesse e a preocupação em relação ao uso de dispositivos tecnológicos pelos adolescentes têm se acentuado a cada dia. As redes sociais da internet têm sido utilizadas pelos jovens não só para a comunicação, mas também para a segregação social. Este trabalho apresenta uma reflexão sobre uma pesquisa e intervenção realizadas em uma escola pública que teve como tema o uso das redes sociais pelos jovens. Para tanto, utilizou-se a metodologia de conversação de orientação psicanalítica com quatro grupos de adolescentes. Depreendeu-se um processo próprio a cada grupo, além de efeitos das conversações sobre cada sujeito.The interest and concern regarding the use of technological devices by adolescents is growing every day. The social networks of the internet have been used by adolescents not only for communication, but also for social segregation. This study analyzes the results of a research intervention carried out in a public school whose subject was the use of social networks by adolescents. For this, it was used a psychoanalytic conversational methodology with four groups of adolescents. It was observed a specific process for each group and the effects of conversations on each subject.El interés y la preocupación por el uso que los adolescentes hacen de los dispositivos tecnológicos son más visibles cada día. Las redes sociales de Internet son utilizadas por los jóvenes no solo para la comunicación, sino también para la segregación social. En este estudio se analizan los resultados de la investigación y la intervención llevada a cabo en una escuela pública cuyo tema fue el uso de las redes sociales por los jóvenes. Para ello, se utilizó la metodología de conversación psicoanalítica con cuatro grupos de adolescentes. Deducimos un proceso específico para cada grupo, además de los efectos de las conversaciones sobre cada sujeto