Scaling test for Wilson twisted mass QCD

We present a first scaling test of twisted mass QCD with pure Wilson quarks for a twisting angle of pi/2. We have computed the vector meson mass and the pseudoscalar decay constant for different values of beta at fixed value of r_0 m_PS. The results obtained in the quenched approximation are compared with data for pure Wilson and non-perturbatively O(a) improved Wilson computations. We show that our results from Wilson twisted mass QCD show clearly reduced lattice spacing errors, consistent with O(a) improvement and without the need of any improvement terms added. These results thus provide numerical evidence of the prediction in ref. [1].Comment: 15 pages, 4 figures; v2: two typos corrected, accepted for publication in Phys. Lett.

Drug interactions of direct oral anticoagulants in elderly patients with cardiometabolic diseases

In the present review we summarized current knowledge about significant interactions (DIs) of direct oral anticoagulants (DOACs) with other medications frequently prescribed to elderly patients with cardiometabolic diseases. Literature search was performed using PubMed from 1990 to October 2020. Randomized clinical trials (RCTs), subgroup analyses from RCTs, longitudinal studies, case series and case reports were included. Only studies in humans were considered. Elderly was defined as ≥75 years. Assessment of DIs with DOACs is often tricky because of the lack of validated tools to routinely assess magnitude of their anti-coagulation effect. Most of reports in the cardiometabolic area regarded the classes of anti-antiarrhythmic, lipid-lowering and platelet-inhibitors drugs, namely drugs that are widely used to reduce cardiovascular risk in patients with common metabolic diseases. Reports about elderly are limited in general, and it is not known whether certain types of DIs occur more frequently in elderly subjects. DIs were more frequently reported in association with dabigatran, which however has been available for a longer period of time compared with other DOACs. In most cases, no complete information about dosages of medications was available. DIs of DOACs leading to adverse events (both ischemic and bleeding ones) were generally facilitated by older age, polymedication and impaired renal function. Further studies should be carried out to properly investigate DIs of DOACs with cardiometabolic drugs in elderly patients, with particular focus on differences between DOACs and the influence of different dosages

Stroke prevention: recent achievements and new challenges

Stroke remains a major health problem despite the great efforts made worldwide to fight against it. Despite therapeutic achievements to treat ischemic stroke patients in stroke units with tissue plasminogen activator (tPA), prevention remains the most powerful strategy to cure this complex disease. Stroke is a heterogeneous and multi-factorial disease caused by the combination of vascular risk factors, environment, and genetic factors. These risk factors can be subdivided into non-modifiable (age, sex, race-ethnicity, genetic variations and predispositions) and modifiable (hypertension, diabetes, dyslipidemia, atrial fibrillation, carotid artery stenosis, smoking, poor diet, physical inactivity and obesity). The metabolic syndrome, a cluster of metabolic risk factors within an individual, has been recognized as and important factor associated with an increased risk of stroke. Recently, a great emphasis has been given to the investigations of genetic factors and stroke risk, which may lead to the discovery of new biomarkers for prevention, diagnosis and to the alternative strategies for stroke treatment. In this review we sought to discuss the main risk factors for stroke and the current strategies of stroke prevention

Evans Syndrome Presented with Marginal Zone Lymphoma and Duodenal Neuroendocrine Tumor in an Elderly Woman

Summary Evans syndrome (ES) is an autoimmune disorder characterized by simultaneous or sequential development of autoimmune hemolytic anemia, immune thrombocytopenia, and/or neutropenia. ES can be classified as a primary (idiopathic) or secondary (associated with an underlying disease) syndrome. We report a case of ES in an elderly patient in the presence of multiple trigger factors such as recent influenza vaccine, marginal zone lymphoma, and neuroendocrine tumor G1. Whether this association is casual or causal remains a matter of speculation. It is however necessary to have a thorough work-up in a newly diagnosed ES and a more accurate search of miscellaneous factors especially in elderly patients

Stroke in young

Stroke is a major healthcare problem ranking as the third leading cause of death and the first cause of disability in the Western countries. Although young adults are at a lower risk of stroke compared to older people, strokes affecting those who are at earlier stages of their productive lives have a greater social impact in terms of number of years of lost productivity and disability. The incidence of stroke in young people ranges between 60 to 200 new cases per year per one million inhabitants, and the overall incidence is about one episode per 100,000 patients per year. Stroke in the young is more frequent in change with industrialized countries, in women, and in blacks and Hispanics compared to whites. In this review we sought to discuss the risk factors, and specific diseases and causes associated with stroke in the young.Moreover, we will discuss the genetic impact on stroke in young, and the outcome and prognosis after stroke among young adults

Ensuring sample quality for biomarker discovery studies - Use of ict tools to trace biosample life-cycle

The growing demand of personalized medicine marked the transition from an empirical medicine to a molecular one, aimed at predicting safer and more effective medical treatment for every patient, while minimizing adverse effects. This passage has emphasized the importance of biomarker discovery studies, and has led sample availability to assume a crucial role in biomedical research. Accordingly, a great interest in Biological Bank science has grown concomitantly. In biobanks, biological material and its accompanying data are collected, handled and stored in accordance with standard operating procedures (SOPs) and existing legislation. Sample quality is ensured by adherence to SOPs and sample whole life-cycle can be recorded by innovative tracking systems employing information technology (IT) tools for monitoring storage conditions and characterization of vast amount of data. All the above will ensure proper sample exchangeability among research facilities and will represent the starting point of all future personalized medicine-based clinical trials

Diabetes-Modifying Antirheumatic Drugs: The Roles of DMARDs as Glucose-Lowering Agents

: Systemic inflammation represents a shared pathophysiological mechanism which underlies the frequent clinical associations among chronic inflammatory rheumatic diseases (CIRDs), insulin resistance, type 2 diabetes (T2D), and chronic diabetes complications, including cardiovascular disease. Therefore, targeted anti-inflammatory therapies are attractive and highly desirable interventions to concomitantly reduce rheumatic disease activity and to improve glucose control in patients with CIRDs and comorbid T2D. Therapeutic approaches targeting inflammation may also play a role in the prevention of prediabetes and diabetes in patients with CIRDs, particularly in those with traditional risk factors and/or on high-dose corticosteroid therapy. Recently, several studies have shown that different disease-modifying antirheumatic drugs (DMARDs) used for the treatment of CIRDs exert antihyperglycemic properties by virtue of their anti-inflammatory, insulin-sensitizing, and/or insulinotropic effects. In this view, DMARDs are promising drug candidates that may potentially reduce rheumatic disease activity, ameliorate glucose control, and at the same time, prevent the development of diabetes-associated cardiovascular complications and metabolic dysfunctions. In light of their substantial antidiabetic actions, some DMARDs (such as hydroxychloroquine and anakinra) could be alternatively termed "diabetes-modifying antirheumatic drugs", since they may be repurposed for co-treatment of rheumatic diseases and comorbid T2D. However, there is a need for future randomized controlled trials to confirm the beneficial metabolic and cardiovascular effects as well as the safety profile of distinct DMARDs in the long term. This narrative review aims to discuss the current knowledge about the mechanisms behind the antihyperglycemic properties exerted by a variety of DMARDs (including synthetic and biologic DMARDs) and the potential use of these agents as antidiabetic medications in clinical settings

Ischemic preconditioning in the younger and aged heart

: Ischemic preconditioning is the effect of brief ischemic episodes which protect the heart from the following more prolonged ischemic episode. This mechanism is effective in younger but not in aged heart. The age-related reduction of ischemic preconditioning has been demonstrated in experimental models and in elderly patients. Preinfarction angina, a clinical equivalent of ischemic preconditioning, reduces mortality in adult but not in elderly patients with acute myocardial infarction. Physical activity or caloric restriction is partially capable to preserve the cardioprotective effect of ischemic preconditioning in the aging heart. More importantly, physical activity and caloric restriction in tandem action completely preserve the protective mechanism of ischemic preconditioning. Accordingly, the protective mechanism of preinfarction angina is preserved in elderly patients with a high grade of physical activity or a low body-mass index. Thus, both physical activity and caloric restriction are confirmed as powerful anti-aging interventions capable to restore age-dependent reduction of a critical endogenous protective mechanism such as ischemic preconditioning

Syncope in the elderly: An update

Abstract Syncope in the elderly is an extremely prevalent clinical condition characterized by high mortality and presence of recurrences. The diagnosis of syncope in the elderly is sometimes difficult and multidimensional geriatric assessment should be carefully administered. Diagnostic algorithms should be applied with attention, although unknown syncope is still frequent. The therapeutic approach to syncope in the elderly is complicated by the high prevalence of neurally-mediated syncope, in which the therapeutic approach is still unknown. The establishment of a "Syncope Unit" has certainly improved the diagnostic-therapeutic approach to patients with syncope, especially in old age where the management is extremely difficult