La valutazione dello stato ossidativo nel paziente critico

Lo stress ossidativo dovuto ad una sovrapproduzione di specie reattive dell’ossigeno e ad una alterata capacità antiossidante, risulta implicato nella patogenesi di molteplici malattie, incluse quelle che ritroviamo maggiormente nel paziente critico. L’obbiettivo del nostro studio è stato quello di comparare la capacità ossidoriduttiva del plasma, nel paziente critico canino all’arrivo, con quella al momento delle dimissioni, dopo la permanenza in terapia intensiva. Inoltre abbiamo cercato una correlazione tra i valori dello stato ossidativo e indici di gravità del paziente. Ai 34 cani inclusi nello studio è stato valutato, sia in entrata che in uscita, lo stato ossidativo con i test d-ROMs e BAP; è stato quindi calcolato, tramite la raccolta di parametri clinici e ematobiochimici, l’indice di gravità (SPI2), un sistema sviluppato per ottenere una previsione della sopravvivenza. Sono stati inoltre determinati i valori serici di Lattati e PCR. I risultati mostrano che tutti i soggetti ricoverati sono in una condizione di stress ossidativo i cui valori cambiano significativamente durante il ricovero con un aumento dei d-ROMs e dei BAP. Le differenze nei valori di d-ROMs tra entrata e uscita risultano influenzate dall’assunzione di antiossidanti durante il ricovero. E’ inoltre emersa una correlazione significativa tra i valori di BAP e SPI2. Dallo studio emerge l’opportunità della valutazione dello stato ossidativo del paziente critico e della somministrazione di antiossidanti, al fine di migliorare i parametri clinici

A new clinical score for cranial CT in ED non-trauma patients: Definition and first validation.

Introduction:Well recognized guidelines are available for the use of cranial computed tomography (CCT) in traumatic patients,while no definitely accepted standards exists to for CCT in patientswithout history of head injury. The aimof this study is to propose an easy clinical score to stratify the need of CCT inemergency department (ED) patients with suspect non-traumatic intracranial pathology. Methods: We retrospectively evaluated patients presenting to the ED for neurological deficit, postural instability, acute headache, alteredmental status, seizures, confusion, dizziness, vertigo, syncope, and pre-syncope.Webuild a score for positive CCT prediction by using a logistic regression model on clinical factors significant at univariate analysis. The score was validated on a population of prospectively observed patients. Results: We reviewed clinical data of 1156 patients; positivity of CCT was 15.2%. Persistent neurological deficit, new onset acute headache, seizures and/or altered state of consciousness, and transient neurological disorders were independent predictors of positive CCT. We observed 508 patients in a validation prospective cohort; CCT was positive in 11.3%. Our score performed well in validation population with a ROC AUC of 0.787 (CI 95% 0.748\u20130.822). Avoiding CT in score 0 patients would have saved 82 (16.2%) exams. No patients with score 0 had a positive CCT findings; score sensitivity was 100.0 (CI 95% 93.7\u2013100.0). Conclusions: A score for risk stratification of patients with suspect of intra-cranial pathology could reduce CT request in ED, avoiding a significant number of CCT while minimizing the risk of missing positive results

Post-exercise high-sensitivity troponin T levels in patients with suspected unstable angina

Background Previous studies showed that troponin blood levels may increase after exercise. In this study we assessed whether, among patients admitted with suspected unstable angina, the increase in high-sensitive troponin T (hs-TnT) levels after exercise stress test (EST) might help identify those with obstructive coronary artery disease (CAD) and predict symptom recurrence during short term follow-up. Methods Maximal treadmill EST was performed in 69 consecutive patients admitted to the emergency room with a suspicion of unstable angina (acute chest pain but confirmed normal serum levels of cardiac troponins) was measured before and 4 hours after EST. Coronary angiography was performed in 22 patients (32.8%). Results hs-TnT increased after EST compared to baseline in the whole population (from 0.84\ub10.65 to 1.17\ub10.87 ng/dL, p<0.001). The increase was similar in patients with positive (n = 14) and negative (n = 55) EST (p = 0.72), and was also similar in patients with (n = 12) and without (n = 10) obstructive CAD at angiography (p = 0.91). The achievement of a heart rate at peak EST \ufffd85% of that predicted for age was the variable mainly associated with the post- EST hs-TnT increase at multivariable linear regression analysis (p = 0.005). The change after EST of hs-TnT did not predict the recurrence of symptoms or readmission for chest pain at 6-month follow-up. Conclusions Our data show that hs-TnT increased after EST in patients with suspected unstable angina, which seemed largely independent of most clinical and laboratory variables. Thus, hs-TnT assessed after EST does not seem to be helpful to identify patients with obstructive CAD in this kind of patients

Effects of phylogenetic associations on environmental and temporal niche partitioning among sympatric mammals

Mammals have evolved to occupy spatial and temporal niches in order to optimize resource utilization and minimize predation risk or competition. Subsequently, niche partitioning may be influenced by phylogenetic associations, which could have substantial consequences for ecosystem structure and function. We use the output from occupancy models based on camera trapping data to construct a tri-partite network describing the environmental and temporal partitioning of activity among twelve sympatric mammals in the Apennine Mountains of central Italy. We further evaluate if there were any effects of phylogenetic associations on the contributions of species to the properties of this spatio-temporal network. The Apennines form a pristine region in central Italy with a relatively intact Mediterranean mammal fauna. The mammal community in our study consisted of species ranging in size from 300 gs to over 200 kg, and included herbivores, omnivores and predators. There was limited structuring of the network describing environmental and temporal niche use. Furthermore, we did not find any phylogenetic signal in species contributions to network structures, and phylogenetic relatedness among species was not associated with their similarities in environmental or spatial niche use. However, animals appeared to have partitioned environmental niches more than temporal ones, suggesting that spatial variation in resource availability may have been more important than temporal avoidance of predation risk or competition in shaping activity within this mammal community. Our study highlights the need to evaluate under which conditions evolutionary history is influencing contemporary ecological processes

Tracking data highlight the importance of human-induced mortality for large migratory birds at a flyway scale

Human-induced direct mortality affects huge numbers of birds each year, threatening hundreds of species worldwide. Tracking technologies can be an important tool to investigate temporal and spatial patterns of bird mortality as well as their drivers. We compiled 1704 mortality records from tracking studies across the African-Eurasian flyway for 45 species, including raptors, storks, and cranes, covering the period from 2003 to 2021. Our results show a higher frequency of human-induced causes of mortality than natural causes across taxonomic groups, geographical areas, and age classes. Moreover, we found that the frequency of human-induced mortality remained stable over the study period. From the human-induced mortality events with a known cause (n = 637), three main causes were identified: electrocution (40.5 %), illegal killing (21.7 %), and poisoning (16.3 %). Additionally, combined energy infrastructure-related mortality (i.e., electrocution, power line collision, and wind-farm collision) represented 49 % of all human-induced mortality events. Using a random forest model, the main predictors of human-induced mortality were found to be taxonomic group, geographic location (latitude and longitude), and human footprint index value at the location of mortality. Despite conservation efforts, human drivers of bird mortality in the African-Eurasian flyway do not appear to have declined over the last 15 years for the studied group of species. Results suggest that stronger conservation actions to address these threats across the flyway can reduce their impacts on species. In particular, projected future development of energy infrastructure is a representative example where application of planning, operation, and mitigation measures can enhance bird conservation

The Old Man and the (C)inema

Within the field of cinema studies, the question of visual representation is a fundamental pillar. An immense volume of theoretical work has been written on the subject, with various academic approaches such as feministic, postcolonial and gay/lesbian. Yet there is a large social group that seems to have been overlooked within the representational discourse: the elderly. This group of people appears to be a blind spot on the multicultural retina, too often neglected within the area of cultural studies. But as the baby boomer generation, who has always redefined the different stages of life (youth, adulthood, middle age), is entering old age, things are slowly changing. Utilizing a post-structural framework, this essay investigates the visual representation of elderly within the cinematic landscape of the western world. Since the subject is somewhat uncharted territory, a broad interdisciplinary approach is necessary where modern social gerontology meets the field of cinema studies. In a cultural context, social grouping based on age implies a distinct position versus the normative, compare to other types of minorities. Changes of sex, skin colour or sexual preference are uncommon, whereas changing age is the fate of every human being. The elderly as the “the Other” is thus every man’s future destiny. This rather unique position carries an immanent paradox since the only way to avoid the periphery in question is death. As a philosophical counterpoint to this rather dystopian outlook, Gilles Deleuze’s theory of becoming is brought into the discussion. The theoretical part of the essay ends with the ontology of age, a historical review of the field of gerontology and the concept of ageism. After a descriptive section, where contemporary examples of film and other media with old age as a main theme are identified, the analytical part of the essay ensues. With the French sociologist Pierre Bourdieu as a theoretical frame of reference, a close reading of the films Avalon (Axel Petersén, 2011), About Schmidt (Alexander Payne, 2002) and RED (Robert Schwentke, 2010) are performed, emphasising aging identity and imposed age-normative behaviour. The semiotics of the aged body is discussed through Jacques Lacans mirror stage and Julia Kristevas abject theory, exemplified by the works of Donigan Cumming. The final part of the essay concerns the great eternal questions within film philosophy: life, death, time and memory, which for the elderly are not merely philosophical concerns but rather notable existential realities. Using Deleuze as a philosophical toolbox, these grand topics are illuminated with examples from The Curious Case of Benjamin Button (David Fincher, 2008), Amour (Michael Haneke, 2012) and Ingmar Bergmans classical works, such as Smultronstället (1957), Saraband (2003) and Gycklarnas afton (1953).