Una nueva nothoespecie de Genista L. (Leguminosae)

Se propone como nueva nothoespecie Genista xaltoportillensis (G. hystrix Lange x G. scorpius (L.) DC.). Se describe, se compara con las especies relacionadas y se estudia la fertilidad del polen.A new nothoespecies, Genista xaltoportillensis (G. hystrix Lange x G. scorpius (L.) DC.), is proposed. It is described and compared with related species. Pollen fertility is also studied.Junta de Castilla y León. Consejería de Educación y CulturaFondo Social Europe

Electronic Health Records: From the Management of Patients to the Research Use of Clinical Data

Paper based medical records are still widespread in Italian hospitals and the workflow to manage outpatients\u2019 visits is critical. Too many isolated software programs coexist in hospital wards and cause confusion and disorganization. A computerized medical record that unifies all the data contained in the various applications should be of fundamental importance in supporting physician\u2019s daily activities. Moreover, with the digital clinical record, data can be re-used for research purposes. The aim of this project is to create a web application for the management of outpatient visits to the Infectious Diseases Unit of the San Martino Hospital in Genoa. In order to orchestrate all the software programs acting in the visit workflow, a client application was developed to speed up the work of the medical staff at the time of the visits, ameliorating the quantity and quality of relevant information from a clinical point of view. A further extension allows standard data exchange between the developed application and the Ligurian HIV Network, which is the main regional research platform

Abdominal fat quantity and distribution in women with polycystic ovary syndrome and extent of its relation to insulin resistance.

CONTEXT: Increased abdominal fat has been linked to insulin resistance and increased cardiovascular risk. Because many patients with polycystic ovary syndrome (PCOS) present abdominal obesity, it may be the cause of insulin resistance in this disorder. SETTING: Fat quantity and distribution were evaluated by dual x-ray absorptiometry at the Departments of Clinical Medicine at the University of Palermo and the University of Naples, Italy. PATIENTS: A total of 110 patients with PCOS and 112 weight-matched controls were studied. Anthropometric data, blood glucose, serum insulin, and testosterone were evaluated. Total, trunk, and central abdominal fat quantity were measured by total-body dual x-ray absorptiometry. RESULTS: Compared with weight-matched controls, patients with PCOS had similar quantity of total and trunk fat but higher quantity of central abdominal fat. This difference was not observed when comparing obese PCOS and obese controls but depended on differences between overweight and normoweight patients and controls. All obese subjects, independently of having PCOS or not, had increased central abdominal fat. The same parameter was increased in 71% of overweight PCOS, 50% of overweight controls, and 30% of normoweight PCOS patients. PCOS patients with increased central abdominal fat had significantly higher (P < 0.01) insulin levels and significantly reduced (P < 0.01) insulin sensitivity than controls with similar quantities of central abdominal fat. Overweight PCOS patients with normal abdominal fat had significantly higher (P < 0.05) insulin levels and significantly reduced (P < 0.05) insulin sensitivity than overweight controls with normal abdominal fat. CONCLUSIONS: Most obese subjects, independent of being affected by PCOS, have an abdominal form of obesity. However, abdominal fat excess may not be the only determinant of insulin resistance in PCOS

Interindividual variability in sweat electrolyte concentration in marathoners

Background: Sodium (Na+) intake during exercise aims to replace the Na+ lost by sweat to avoid electrolyteimbalances, especially in endurance disciplines. However, Na+ needs can be very different among individuals because of the great inter-individual variability in sweat electrolyte concentration. The aim of this investigation was to determine sweat electrolyte concentration in a large group of marathoners. Methods: A total of 157 experienced runners (141 men and 16 women) completed a marathon race (24.4 ± 3.6 °C and 27.7 ± 4.8 % of humidity). During the race, sweat samples were collected by using sweat patches placed on the runners’ forearms. Sweat electrolyte concentration was measured by using photoelectric flame photometry. Results: As a group, sweat Na+ concentration was 42.9 ± 18.7 mmol·L−1 (minimal-maximal value = 7.0–95.5 mmol·L−1), sweat Cl− concentration was 32.2 ± 15.6 mmol·L−1 (7.3–90.6 mmol·L−1) and sweat K+ concentration was 6.0 ± 0.9 mmol·L−1 (3.1–8.0 mmol·L−1). Women presented lower sweat Na+ (33.9 ± 12.1 vs 44.0 ± 19.1 mmol·L−1; P = 0.04) andsweat Cl− concentrations (22.9 ± 10.5 vs 33.2 ± 15.8 mmol·L−1; P = 0.01) than men. A 20 % of individuals presented asweat Na+ concentration higher than 60 mmol·L−1 while this threshold was not surpassed by any female marathoner. Sweat electrolyte concentration did not correlate to sweat rate, age, body characteristics, experience or training. Although there was a significant correlation between sweat Na+ concentration and running pace (r = 0.18; P = 0.03), this association was weak to interpret that sweat Na+ concentration increased with running pace. Conclusions: The inter-individual variability in sweat electrolyte concentration was not explained by any individual characteristics except for individual running pace and sex. An important portion (20 %) of marathoners might need special sodium intake recommendations due to their high sweat salt losses

Pregnancy and neonatal outcomes among a cohort of HIV-infected women in a large Italian teaching hospital : a 30-year retrospective study

The primary study objective was to investigate three decades from 1985 to 2014 of changes in pregnancies among HIV-infected women. The secondary objective was to assess risk factors associated with preterm delivery and severe small-for-gestational-age (SGA) infants in HIV-infected women. A retrospective review of deliveries among pregnant HIV-infected women at the University of Genoa and IRCCS San Martino-IST in Genoa between 1985 and 2014 was performed. Univariate and multivariable analyses were used to study the variables associated with neonatal outcomes. Overall, 262 deliveries were included in the study. An increase in median age (26 years in 1985-1994 vs. 34 years in 2005-2014), in the proportion of foreigners (none in 1985-1994 vs. 27/70 (38\ub76%) in 2005-2014), and a decrease in intravenous drug use (75\ub72% (91/121) in 1985-1994 vs. 12\ub79% (9/70) in 2005-2014) among pregnant HIV-infected women was observed. Progressively, HIV infections were diagnosed sooner (prior to pregnancy in 80% (56/70) of women in the last decade). An increase in combined antiretroviral therapy (cART) prescription during pregnancy (50% (27/54) in 1995-2004 vs. 92\ub72% (59/64) in 2005-2014) and in HIV-RNA &lt;50 copies/ml at delivery (19\ub72% (5/26) in 1995-2004 vs. 82\ub73% (53/64) in 2005-2014) was observed. The rate of elective caesarean section from 1985 to 1994 was 9\ub71%, which increased to 92\ub73% from 2004 to 2015. Twelve (10\ub71%) mother-to-child transmissions (MTCT) occurred in the first decade, and six (8\ub73%) cases occurred in the second decade, the last of which was in 2000. Preterm delivery (&lt;37 weeks gestation) was 5% (6/121) from 1985 to 1994 and increased to 17\ub71% (12/70) from 2005 to 2014. In univariate and multivariable logistic regression analyses, advancing maternal age and previous pregnancies were associated with preterm delivery (odds ratio (OR) 2\ub77; 95% confidence intervals (CI) 1-7\ub78 and OR 2\ub76; 95% CI 1\ub71-6\ub77, respectively). In the logistic regression analysis, use of heroin or methadone was found to be the only risk factor for severe SGA (OR 3\ub71; 95% CI 1\ub74-6\ub78). In conclusion, significant changes in demographic, clinical and therapeutic characteristics of HIV-infected pregnant women have occurred over the last 30 years. Since 2000, MTCT has decreased to zero. An increased risk of preterm delivery was found to be associated with advancing maternal age and previous pregnancies but not with cART. The use of heroin or methadone has been confirmed as a risk factor associated with severe SGA

Effectiveness and safety profile of tofacitinib and baricitinib in rheumatoid arthritis patients: results from a 24-month real-life prospective study in Southern-Italy

The primary objectives of the study were to evaluate the efficacy and safety of tofacitinib and baricitinib up to 24 months of follow-up in patients with rheumatoid arthritis (RA) treated in Southern Italy. Patients' data, activity index, and clinimetric scores were collected at baseline (T0), six (T6), twelve (T12), and twenty-four (T24) months following treatment initiation. At six, twelve, and twenty-four months, adverse events and treatment cessation were also recorded. Sixty-eight patients (mean age: 62.2±10.9 years; mean RA duration: 15±9.6 years) were enrolled over a period of 12 weeks. At baseline, twenty-four patients (35.3%) were treated with tofacitinib, and forty-four patients (64.7%) were treated with baricitinib. The baseline mean disease activity was moderate as measured by DAS28- ESR (5.0±1.0), DAS 28 CRP (4.69±0.94), and SDAI (26.87±10.73) score. Before beginning JAKinhibs therapy, thirty-two patients (61.8%) were taking bDMARDs, while the remaining thirty-six (38.2%) were bDMARDs-naïve. The 24-month retention rate for JAKinhibs was 91.1%. Six months after beginning treatment with JAKinhibs, a statistically significant improvement was observed in all evaluated activity indices and clinimetric scores. Improvement was confirmed during the 12- and 24-month follow-up evaluations. The positive correlation between baseline-T6 SDAI delta and discontinuation of JAKinhibs (p=0.02) suggests that RA worsening in the first six months may be a predictor of therapy withdrawal. Patients with RA responded favorably to tofacitinib and baricitinib in this prospective, real-world study from a single center in Southern Italy. Efficacy was observed despite an underlying persistent and treatment-resistant disease

Clinical Experience with Ceftazidime-Avibactam for the Treatment of Infections due to Multidrug-Resistant Gram-Negative Bacteria Other than Carbapenem-Resistant Enterobacterales

Experience in real clinical practice with ceftazidime-avibactam for the treatment of serious infections due to gram-negative bacteria (GNB) other than carbapenem-resistant Enterobacterales (CRE) is very limited

A caffeinated energy drink improves jump performance in adolescent basketball players

This study aimed at investigating the effects of a commercially available energy drink on shooting precision, jump performance and endurance capacity in Young basketball players. Sixteen young basketball players (first division of a junior national league; 14.9 ± 0.8 years; 73.4 ± 12.4 kg; 182.3 ± 6.5 cm) volunteered to participate in the research. They ingested either (a) an energy drink that contained 3 mg of caffeine per kg of body weight or (b) a placebo energy drink with the same appearance and taste. After 60 min for caffeine absorption, they performed free throw shooting and three-point shooting tests. After that, participants performed a maximal countermovement jump (CMJ), a repeated maximal jumps test for 15 s (RJ-15), and the Yo–Yo intermittent recovery test level 1 (Yo–Yo IR1). Urine samples were obtained before and 30 min after testing. In comparison to the placebo, the ingestion of the caffeinated energy drink did not affect precision during the free throws (Caffeine = 70.7 ± 11.8 % vs placebo = 70.3 ± 11.0 %; P = 0.45), the three-point shooting test (39.9 ± 11.8 vs 38.1 ± 12.8 %; P = 0.33) or the distance covered in the Yo–Yo IR1 (2,000 ± 706 vs 1,925 ± 702 m; P = 0.19). However, the energy drink significantly increased jump height during the CMJ (38.3 ± 4.4 vs 37.5 ± 4.4 cm; P\0.05) mean jump height during the RJ-15 (30.2 ± 3.6 vs 28.8 ± 3.4 cm; P\0.05) and the excretion of urinary caffeine (1.2 ± 0.7 vs 0.1 ± 0.1 lg/mL; P\0.05). The intake of a caffeine-containing energy drink (3 mg/kg body weight) increased jump performance although it did not affect basketball shooting precision

Prevalence and incidence of osteoporotic fractures in patients on long-term glucocorticoid treatment for rheumatic diseases: The glucocorticoid induced OsTeoporosis TOol (GIOTTO) study

Osteoporosis and fractures are common and invalidating consequences of chronic glucorticoid (GC) treatment. Reliable information regarding the epidemiology of GC induced osteoporosis (GIOP) comes exclusively from the placebo group of randomized clinical trials while observational studies are generally lacking data on the real prevalence of vertebral fractures, GC dosage and primary diagnosis. The objective of this study was to evaluate the prevalence and incidence of osteoporotic fractures and to identify their major determinants (primary disease, GC dosage, bone mineral density, risk factors, specific treatment for GIOP) in a large cohort of consecutive patients aged &gt;21 years, on chronic treatment with GC ( 655 mg prednisone - PN - equivalent) and attending rheumatology centers located all over Italy. Glucocorticoid Induced OsTeoporosis TOol (GIOTTO) is a national multicenter cross-sectional and longitudinal observational study. 553 patients suffering from Rheumatoid Arthritis (RA), Polymyalgia Rheumatica (PMR) and Connective Tissue Diseases (CTDs) and in chronic treatment with GCs were enrolled. Osteoporotic BMD values (T score &lt;-2.5) were observed in 28%, 38% and 35% of patients with CTDs, PMR or RA at the lumbar spine, and in 18%, 29% and 26% at the femoral neck, respectively. Before GC treatment, prevalent clinical fractures were reported by 12%, 37% and 17% of patients with CTDs, PMR, or RA, respectively. New clinical fragility fractures during GC treatment were reported by 12%, 10% and 23% of CTDs, PMR and RA patients, respectively. Vertebral fractures were the prevailing type of fragility fracture. More than 30% of patients had recurrence of fracture. An average of 80% of patients were in supplementation with calcium and/or vitamin D during treatment with GCs. Respectively, 64%, 80%, and 72% of the CTDs, PMR and RA patients were on pharmacological treatment for GIOP, almost exclusively with bisphosphonates. The GIOTTO study might provide relevant contributions to clinical practice, in particular by highlighting and quantifying in real life the prevalence of GIOP and relative fractures, the frequency of the main risk factors, and the currently sub-optimal prevention. Moreover, these results emphasize the importance of the underlying rheumatic disease on the risk of GIOP associated fractures

Grupo de expertos del PAPPS. Recomendaciones sobre el estilo de vida

Los determinantes de salud primarios y secundarios explican gran parte de la morbimortalidad observada en atención primaria. Se presentan las recomendaciones del Programa de Actividades Preventivas y Promoción de la Salud (PAPPS) de la semFyC, para la promoción de un estilo de vida saludable mediante la metodología de intervención y las actuaciones preventivas en consumo de tabaco, consumo de alcohol, alimentación saludable, actividad física en el tiempo libre, prevención de accidentes de tráfico y sistemas de retención infantil. Se señalan las pautas más comunes de prevención clínica. Se actualizan las recomendaciones, se señalan aspectos novedosos como la definición de consumo de alcohol de bajo riesgo y se pone al día la bibliografía. Para las principales recomendaciones se incluyen tablas específicas que recogen la calidad de la evidencia y la fuerza de la recomendación. Primary and secondary health determinants explain a large part of the morbidity and mortality observed in primary care. The recommendations of the Program of Preventive Activities and Health Promotion (PAPPS) of the semFyC are presented, for the promotion of a healthy lifestyle through intervention methodology and preventive actions in tobacco consumption, alcohol consumption, healthy eating, physical activity in free time and prevention of traffic accidents and child restraint systems. The most common clinical prevention guidelines are outlined. The recommendations are updated, new aspects are pointed out, such as the definition of low-risk alcohol consumption, and the bibliography is updated. For the main recommendations, specific tables are included that show the quality of the evidence and the strength of the recommendation