Blood urea nitrogen to creatinine ratio is associated with congestion and mortality in heart failure patients with renal dysfunction

Renal dysfunction (RD) and venous congestion are related and common in heart failure (HF). Studies suggest that venous congestion may be the primary driver of RD in HF. In this study, we sought to investigate retrospectively the relationship between common measures of renal function with caval congestion and mortality among outpatients with HF and RD. We reviewed data from 103 HF outpatients (45 males, mean age 74 years, ejection fraction 41.8 ± 11.6 %) with estimated glomerular filtration rate (eGFR) of 25.5 (adjusted OR 2.98, p 0.015) and eGFR ≤45.8 (adjusted OR 5.38, p 0.002) identify patients at risk for caval congestion; a BUN/Cr >23.7 was the best predictor of impaired collapsibility (adjusted OR 4.41, p 0.001). a BUN/Cr >25.5 (HR 2.19, 95 % CI 1.21-3.94, p < 0.001) and NYHA class 3 (HR 2.91, 95 % CI 1.60-5.31, p < 0.0005) were independent risk factors associated with all-cause death during a median follow-up of 31 months. In outpatients with HF and RD, a higher BUN/Cr and lower eGFR are reliable renal biomarkers for caval congestion. The BUN/Cr is associated with long-term mortality and may help to stratify HF severity

Coupling Lagrangian simulation models and remote sensing to explore the environmental effect on larval growth rate: The Mediterranean case study of round sardinella (Sardinella aurita) early life stages

The relationship between environmental conditions and early life-history traits of Sardinella aurita are investigated using material collected in two sites of the Central Mediterranean Sea. Individual mean daily growth during the planktonic phase has been determined by using otolith microstructure analysis, while Lagrangian simulation models allowed to estimate the daily position in space and time of each specimen from the hatching to the catch. Generalized Additive Mixed Models (GAMMs) have been implemented to explore the impact of environmental conditions at time t, t-1 day and t-2 days on the mean daily growth rate occurring at time t. Spatial analysis evidenced a wide dispersion of eggs and larvae in the coastal area of both sampling sites in correspondence to relatively warmer and chlorophyll-a enriched waters. Lagrangian simulations detected a complementary larval dispersal pathway able to transport larvae to a known retention area. Temperature at time t was the most important driver affecting the mean daily larval growth, followed by the food availability. On the other hand, models performed on lagged environmental covariates (t-1 and t-2) did not show any significant effect on the growth rate at time t. In addition to the sub-linear positive correlation between temperature and mean daily larval growth, model highlighted a decrease in the otolith core width at higher temperature that can be linked to an earlier stage of ontogeny at hatching. This study provided a useful methodological approach that takes advantage of available remote sensing data to perform ecological studies in support to fisheries management

The power of video in science communication: the EDUlab media production

Avvicinare la scienza e la ricerca alle persone, in ogni aspetto, significa avvicinare il pubblico a temi complicati, inspirando buone norme comportamentali di rispetto e tutela ambientale ma anche avvicinare la scienza a chi ogni giorno è in grado di decidere, attraverso i finanziamenti, quali lavori scientifici supportare. Proprio in coscienza di questo, negli ultimi decenni la scienza ha smesso di essere autoreferenziale, comprendendo che divulgare contenuti altamente scientifici a ad un pubblico non specialistico è fondamentale. Divulgare vuol dire creare quell’anello di congiunzione tra la ricerca scientifica più avanzata e il pubblico, significa saper capire il linguaggio spesso criptico dei ricercatori e di adattarlo senza stravolgimenti in qualcosa di comprensibile alle persone comuni. Con questa mission, nel 2015 nasce ufficialmente il gruppo “EDULab dell’IAS-CNR di Capo Granitola”, ovvero un laboratorio creativo di divulgazione scientifica in cui ricercatori, tecnologi e tecnici di varie discipline che condividono la passione di divulgare la scienza e i risultati da essa prodotti nei propri ambiti di competenza. Nel tempo, l’attività del gruppo si è consolidata, portando a numerosi risultati e ad un numero ragguardevole di progetti e programmi. Tra gli innumerevoli prodotti divulgativi sviluppati, l’uso dei media, ed in particolare dei video, si è rivelato uno strumento eccezionale di “comunicazione empatica” attraverso cui il pubblico riesce ad “immergersi” letteralmente nei contenuti proposti, recependo e facendo propri contenuti anche molto complessi. Nell’era del web e dei social-media, infatti, i video sono ormai lo strumento più veloce ed efficace per veicolare informazioni ad un’ampia fetta di popolazione

IN "POLPO ... SITION" E ALTRI BREVI RACCONTI

Assalito dalla felicità corsi al mare, guardai l’acqua e fui preso da una forza, non mia, non umana che mi trascinò in acqua. Lì venni rapito da fantastiche sensazioni, l’adrenalina salì a mille, vidi un enorme creatura che suscitò in me delle emozioni mai provate prima, si era avvicinata talmente tanto che stava per toccarmi e, appena lo fece, il mio corpo si illuminò magicamente, le mie mani iniziarono pian piano ad assottigliarsi, il mio petto diventava sempre più piccolo e tondo e da lì a poco, ero diventato un polpo

Heart rate variability in sick sinus syndrome: does it have a diagnostic role?

BACKGROUND: Hypothesis of our study was that the irregular rhythm of sick sinus syndrome (SSS) was characterized by an augmented HRV. Objective was to assess whether SSS patients had a typical HRV profile.METHODS: We screened all 1947 consecutive Holter ECGs performed in our Units of Vascular Medicine and Internal Medicine and Cardioangiology at the University of Palermo (Italy) from April 2010 to September 2014. Among these, we selected 30 patients with ECG criteria of SSS. They were compared to 30 patients without SSS matched for age, sex and comorbidities.RESULTS: The SSS group had a lower mean heart rate (HR) (P=0.003), and a longer mean NN max-min longer (P&lt;0.0005) compared to control group. SSS group had higher mean pNN50 (P=0.043), mean RMSSD (P=0.006), mean SDNN (P 0.021), and mean SDNNi (P=0.005) as compared with control group. Moreover. HR &lt;= 64.5 bpm, NN maxmin&gt; 1355 cosec. pNN50&gt; 16.08, RMSSD&gt;50.2, SDNN&gt;151.94, and SDNNi&gt;71.1 showed a predictive value for diagnosis of SSS. The positivity of all 6 variables according to the aforementioned cut-offs ensured a positive predictive value of 100% and the negativity of all 6 variables had a negative predictive value of 94% for diagnosis of SSS. Among SSS patients, we did not observe any correlation between HR and HRV variables.CONCLUSIONS: SSS patients have a HRV profile characterized by: low HR, long NN max-min interval, and elevated pNN50, RMSSD, SDNN and SDNNi values with specific diagnostic cut-offs for diagnosis of SSS. Moreover, we found the absence of correlation between HR and all time-domain HRV variables in SSS patients

Applicazione di un protocollo di screening differenziale nel sistema Vitis vinifera per l’identificazione di peptidi con attività antimicrobica

Le piante e gli animali presentano elementi comuni nel loro sistema di difesa contro gli agenti patogeni, come la sintesi diretta di enzimi idrolitici (chitinasi, glucanasi, proteinasi e ossidasi) e di peptidi antimicrobici (AMPs). Gli AMPs sono peptidi ampiamente espressi negli organismi animali (vertebrati e invertebrati) e nelle piante. Possono essere espressi costitutivamente o rapidamente indotti inseguito ad uno stimolo biotico, a differenti livelli cellulari, per interagire direttamente con l’agente infettante e/o per modulare la risposta immunitaria contro i patogeni. Tali peptidi sono oggi classificati in relazione alle loro caratteristiche biochimiche (carica netta) e/ o alle loro caratteristiche strutturali (composizione amminoacidica, struttura lineare o circolare). In base a queste caratteristiche le molecole possono essere distinte nei seguenti gruppi: 1) peptidi lineari ad alfa elica; 2) peptidi ciclici con β-sheets e due o più ponti disolfuro; 3) peptidi con alfa elica e β-sheets stabilizzati da ponti disolfuro; 4) peptidi con hairpin o loop stabilizzati da ponti disolfuro; 5) peptidi lineari con residui aminoacidici ripetuti, come prolina, glicina, triptofano o istidina; 6) piccoli peptidi con struttura avvolta o con una struttura secondaria non definita. Nonostante la loro diversità strutturale, i peptidi antimicrobici presentano la caratteristica comune di inibire la crescita di un largo spettro di microbi, quali Gram-positivi, Gram-negativi, funghi e in alcuni casi anche virus, tanto da far coniare il termine di “antibiotici naturali”. Negli ultimi anni è notevolmente incrementato l’interesse verso tali peptidi dal momento che dati scientifici hanno mostrato che questi non inducono lo sviluppo di meccanismi di resistenza nei microrganismi patogeni. Gli AMPs quindi potrebbero costituire una valida alternativa non solo in ambito sanitario, per la sostituzione di antibiotici di sintesi chimica e di origine microbiologica, ma potrebbero avere un importante utilizzo in campo industriale e nello sviluppo di nuovi sistemi di conservazione degli alimenti al fine di incrementare la loro “shelf-life”

Autonomic dysfunction in a group of lower extremities arterial disease outpatients

Background: The understanding of the specific role of sympathetic neural control and dysregulation in lower extremities arterial disease (LEAD) is still very limited. Aim of our study was to investigate the autonomic profile in LEAD patients and to evaluate if the eventual autonomic alterations were more severe in patients with advanced disease. Methods: We enrolled all consecutive outpatients with LEAD referred to our Departments between July 2012 and September 2014. They were compared to a group of matched outpatients without LEAD. All patients underwent Holter ECG monitoring. Time-domain analysis of heart rate variability (HRV) was evaluated. Results: Compared to controls, patients with LEAD had a lower SDNN (P=0.007) and SDANN (P=0.003). Patients with clinically advanced LEAD had a lower SDNN (P=0.006) and SDANN (P=0.004) compared to LEAD patients with less severe disease and to those without disease. Conclusions: LEAD patients had a reduced SDNN and SDANN than patients without LEAD. Autonomic dysfunction was more significant in clinically advanced stages of disease. This association did not relate to ABI value but to clinical stage of disease

Right ventricular diameter predicts all-cause mortality in heart failure with preserved ejection fraction

Left ventricular ejection fraction (EF) is helpful to differentiate heart failure (HF) phenotype in clinical practice. The aim of the study was to identify simple echocardiographic predictors of post-discharge all-cause mortality in hospitalized HF patients. Patients with acute HF (75 ± 9.8 years), classified in preserved (≥ 50%) and reduced (&lt; 50%) EF (HFpEF and HFrEF, respectively), were enrolled. The mean follow-up period was of 25.4 months. Patients definitively analyzed were 135. At multivariate Cox model, right ventricular diameter (RVd), inferior vena cava diameter (IVCd) and blood urea nitrogen (BUN) resulted to be significantly associated with all-cause mortality in HFpEF (HR 2.4, p = 0.04; HR 1.06, p = 0.02; HR 1.02, p = 0.01), whereas, left atrial volume (LAV) was significantly associated with mortality in HFrEF (HR 1.06, p = 0.006). Excluding LAV from the model, only COPD remained an independent predictor of all-cause mortality (HR 2.15, p = 0.04) in HFrEF. At Kaplan–Meier analysis, no differences of survival between HFrEF and HFpEF were found, however, significantly increased all-cause mortality for higher values of basal-RVd, BUN, and IVCd (log-rank p = 0.0065, 0.0063, 0.0005) in HFpEF, and for COPD and higher LAV (log-rank p = 0.0046, p = 0.033) in HFrEF. These data are indicative that in patients hospitalized with HF, EF is not a suitable predictor of long-term all-cause mortality, whereas, right ventricular volumetric remodeling and IVCd have a prognostic role in HFpEF as well as LAV in HFrEF. Our study suggests that besides EF, other echocardiographic parameters are helpful to optimize the phenotyping and prognostic stratification of HF